Adult transverse sinus capillary hemangioma: case report and review of the literature

Background

Adult intracranial capillary hemangioma (ICH) is an extremely rare disease with very few cases reported in the literature. Natural history is poorly understood and therapeutic management has not been clearly defined.

Methods

Using PRISMA guidelines, we systematically reviewed all published adult cases of ICH, to which we added our own case.

Case presentation

A 24-year-old patient with intracranial hypertension underwent stenting for left transverse sinus ICH. Recurrence was managed by subtotal resection, and radiotherapy was undertaken after a second relapse. Radiotherapy achieved complete response at last follow-up.

Results

Among cases of ICH found in the literature, 36 concerned adults (55.3%), with clear female predominance, and only 2 cases affecting the transverse sinus (8.1%). Adult ICHs grew over time, and pregnancy seemed to accelerate natural progression. Complete resection was achieved in most cases, and radiotherapy was used in case of relapse, with high rates of tumor control.

Conclusion

Transverse sinus ICH is uncommon, and venous stenting is a suitable option in case of tumor invasion to treat intracranial hypertension. Surgery is the gold-standard treatment, and radiotherapy is a very effective alternative, with high rates of tumor control. Natural history is not benign, particularly in case of pregnancy.