Background: By definition, a cavernous sinus is a vascular plexus. A hemangioma is a vascular tumor which is rich in vascular plexus and caused by vascular deformity or tumor-like proliferation. Radiosurgery can effectively control the growth of smaller cavernous sinus hemangiomas (CSHs). This paper aimed to quantify the MRI characteristics of CSHs which provided a basis for further treatment. Methods: A retrospective analysis was conducted of the MRI characteristics of 133 cavernous sinus lesion patients between January 2006 and December 2009, and none of them was diagnosed without histology. Two groups were set apart according to the pathological results: a CSH group (24 patients) and a non-CSH group (109 patients). The latter was further divided into 3 categories: a meningioma group (33 patients), a neurilemmoma group (37 patients) and a miscellaneous group (39 patients). A single-factor χ2 analysis was performed to analyze the data on the 12 MRI characteristics. Results: T2-weighted ultrahigh signal, signal uniformity, dumbbell-like appearance and infiltration of the sellar region were considered statistically significant for the differentiation of CSHs from non-CSHs. If these 4 items served as the diagnostic criteria, the sensitivity, specificity and accuracy was 87.5, 96.3 and 94.7%, respectively. Conclusion: Smaller CSHs can be treated by radiosurgery directly, without performance of a pathological biopsy.

1.
Fraser JF, Mass AY, Brown S, Anand VK, Schwartz TH: Transnasal endoscopic resection of a cavernous sinus hemangioma: technical note and review of the literature. Skull Base 2008;18:309-315.
2.
Bradac O, Majovsky M, de Lacy P, Benes V: Surgery of brainstem cavernous malformations. Acta Neurochir (Wien) 2013;155:2079-2083.
3.
Kondziolka D, Monaco EA 3rd, Lunsford LD: Cavernous malformations and hemorrhage risk. Prog Neurol Surg 2013;27:141-146.
4.
Patibandla MR, Thotakura AK, Panigrahi MK: Third ventricular cavernous malformation: an unusual lesion. Br J Neurosurg 2014;28:110-112.
5.
Wang X, Mei G, Liu X, Dai J, Pan L, Wang E: The role of stereotactic radiosurgery in cavernous sinus hemangiomas: a systematic review and meta-analysis. J Neurooncol 2012;107:239-245.
6.
Murphy RK, Reynolds MR, Mansur DB, Smyth MD: Gamma knife surgery for a hemangioma of the cavernous sinus in a child: case report. J Neurosurg Pediatr 2013;11:74-78.
7.
Zheng X, Xu C, di Lorenzo A, Kleaveland B, Zou Z, Seiler C, Chen M, Cheng L, Xiao J, He J, et al: CCM3 signaling through sterile 20-like kinases plays an essential role during zebrafish cardiovascular development and cerebral cavernous malformations. J Clin Invest 2010;120:2795-2804.
8.
Kida Y, Kobayashi T, Mori Y: Radiosurgery of cavernous hemangiomas in the cavernous sinus. Surg Neurol 2001;56:117-122, discussion 122-123.
9.
Jinhu Y, Jianping D, Xin L, Yuanli Z: Dynamic enhancement features of cavernous sinus cavernous hemangiomas on conventional contrast-enhanced MR imaging. AJNR Am J Neuroradiol 2008;29:577-581.
10.
Gonzalez LF, Lekovic GP, Eschbacher J, Coons S, Porter RW, Spetzler RF: Are cavernous sinus hemangiomas and cavernous malformations different entities? Neurosurgical Focus 2006;21:e6.
11.
Linskey ME: Cavernous sinus hemangiomas; in Hay D, Wass JAH (eds): Clinical Endocrine Oncology, ed 2. Oxford, Blackwell, 2009, pp 318-324.
12.
Chou CW, Wu HM, Huang CI, Chung WY, Guo WY, Shih YH, Lee LS, Pan DHC: Gamma knife surgery for cavernous hemangiomas in the cavernous sinus. Neurosurgery 2010;67:611-616.
13.
Skeie BS, Enger P, Skeie G, Thorsen F, Pedersen P: Gamma knife surgery of meningiomas involving the cavernous sinus: long-term follow-up of 100 patients. Neurosurgery 2010;66:661-669.
14.
Peker S, Kılıç T, Şengöz M, Pamir M: Radiosurgical treatment of cavernous sinus cavernous haemangiomas. Acta Neurochir (Wien) 2004;146:337-341.
15.
Yamamoto M, Kida Y, Fukuoka S, Iwai Y, Jokura H, Akabane A, Serizawa T: Gamma knife radiosurgery for hemangiomas of the cavernous sinus: a seven-institute study in Japan. J Neurosurg 2010;112:772-779.
16.
Pan DHC, Chung WY, Wu HM, Yang HC, Lee CC, Liu KD: Cavernous sinus hemangiomas treated with gamma knife surgery; in Hayat MA (ed): Tumors of the Central Nervous System. Berlin, Springer, 2012, vol 9, pp 215-223.
17.
Zhao Y, Mao Y, Zhou L, Zhang Y: Immunohistochemical study on central nervous system cavernous hemangiomas (in Chinese). Zhonghua Yi Xue Za Zhi 2003;83:544-547.
18.
Wu W, Tanrivermis Sayit A, Vinters HV, Pope W, Misradraei L, Said J: Primary central nervous system histiocytic sarcoma presenting as a postradiation sarcoma: case report and literature review. Hum Pathol 2013;44:1177-1183.
19.
Acciarri N, Galassi E, Giulioni M, Pozzati E, Grasso V, Palandri G, Badaloni F, Zucchelli M, Calbucci F: Cavernous malformations of the central nervous system in the pediatric age group. Pediatr Neurosurg 2009;45:81-104.
20.
Zhao Y, Tan YZ, Zhou LF, Wang HJ, Mao Y: Morphological observation and in vitro angiogenesis assay of endothelial cells isolated from human cerebral cavernous malformations. Stroke 2007;38:1313-1319.
21.
Zhou LF, Mao Y, Chen L: Diagnosis and surgical treatment of cavernous sinus hemangiomas: an experience of 20 cases. Surg Neurol 2003;60:31-36.
22.
Grosu AL, Nieder C: Stereotactic fractionated radiotherapy for recurrent capillary hemangioma of the cavernous sinus. Strahlenther Onkol 2006;182:179-182.
23.
Jinhu Y, Jianping D, Xin L, Yuanli Z: Dynamic enhancement features of cavernous sinus cavernous hemangiomas on conventional contrast-enhanced MR imaging. AJNR Am J Neuroradiol 2008;29:577-581.
24.
Mendonça JL, Viana SL, Matsumine M, Silva RF, Viana MA, Freitas FM: Cavernous angioma of the cavernous sinus: imaging findings. Arq Neuropsiquiatr 2004;62:1004-1007.
25.
Salanitri GC, Stuckey SL, Murphy M: Extracerebral cavernous hemangioma of the cavernous sinus: diagnosis with MR imaging and labeled red cell blood pool scintigraphy. AJNR Am J Neuroradiol 2004;25:280-284.
26.
Sohn CH, Kim SP, Kim IM, Lee JH, Lee HK: Characteristic MR imaging findings of cavernous hemangiomas in the cavernous sinus. AJNR Am J Neuroradiol 2003;24:1148-1151.
27.
Suri A, Ahmad FU, Mahapatra AK: Extradural transcavernous approach to cavernous sinus hemangiomas. Neurosurgery 2007;60:483-489.
28.
Wang X, Liu X, Mei G, Dai J, Pan L, Wang E: Phase II study to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas. Int J Radiat Oncol Biol Phys 2012;83:e223-e230.
29.
Gliemroth J, Missler U, Sepehrnia A: Cavernous angioma as a rare neuroradiologic finding in the cavernous sinus. J Clin Neurosci 2000;7:554-557.
30.
Liu X, Xu D, Zhang Y, Liu D, Song G: Gamma knife surgery in patients harboring orbital cavernous hemangiomas that were diagnosed on the basis of imaging findings. J Neurosurg 2010;113(suppl):39-43.
31.
Nuss DW, O'Malley B: Surgery of the anterior and middle cranial base; in Cummings CW (ed): Cumming's Otolaryngology Head and Neck Surgery, ed 4. St Louis, Elsevier Mosby, 2005, pp 3760-3775.
32.
Kuo JS, Chen JC, Yu C, Zelman V, Giannotta SL, Petrovich Z, MacPherson D, Apuzzo ML: Gamma knife radiosurgery for benign cavernous sinus tumors: quantitative analysis of treatment outcomes. Neurosurgery 2004;54:1385-1394.
33.
Thompson TP, Lunsford LD, Flickinger JC: Radiosurgery for hemangiomas of the cavernous sinus and orbit: technical case report. Neurosurgery 2000;47:778-783.
34.
Hasiloglu ZI, Asik M, Kizilkilic O, Albayram S, Islak C: Cavernous hemangioma of the cavernous sinus misdiagnosed as a meningioma: a case report and MR imaging findings. Clin Imaging 2013;37:744-746.
35.
Li P, Ren H, Zhang S, Wang W: Clinical results of gamma knife surgery for cavernous sinus hemangiomas. Surg Neurol 2012;117(suppl):89-95.
36.
Bourekas EC, Slone HW, Ray-Chaudhury A: Masses of the sellar and junxtasellar region; in Drevelegas A (ed): Imaging of Brain Tumors with Histological Correlations. Berlin, Springer, 2011, pp 325-371.
37.
Kida Y, Kobayashi T, Mori Y: Radiosurgery of cavernous hemangiomas in the cavernous sinus. Surg Neurol 2001;56:117-122.
38.
Yao Z, Feng X, Chen X, Zee C: Magnetic resonance imaging characteristics with pathological correlation of cavernous malformation in cavernous sinus. J Comput Assist Tomogr 2006;30:975-979.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.