Intracranial capillary hemangioma: extra-axial tumorous lesions closely mimicking meningioma

Capillary hemangiomas are common tumorous lesions of the skin and soft tissue in infants. These lesions often involve internal organs and rarely develop in the intracranial space. Because of their rarity, clinical descriptions of intracranial capillary hemangioma have been anecdotal and have not provided a coherent understanding of these lesions. We report four cases of intracranial capillary hemangioma. Review of these 4 cases and 14 cases reported in the literature was undertaken to assess the influence of age, sex, location, clinical manifestation, treatment, and outcome. A significant difference was observed in age at diagnosis between sexes. The median age for male patients was 4.8 years (range 6 weeks to 20 years), and the median age for female patients was 22.5 years (range 4 months to 44 years). Approximately two-thirds of intracranial capillary hemangioma lesions develop in the vicinity of major venous sinuses, such as the cavernous/sphenoparietal sinus and the transverse sinus/torcular/superior sagittal sinus. This propensity for specific locations appears to be responsible for the symptom manifestation. The majority of the lesions also seem to be extra-axial in imaging and operative findings. Complete surgical resection provided excellent outcome, but incomplete resection led to recurrence. Capillary hemangioma should be considered in the diagnosis of extra-axial, contrast-enhancing lesions, especially in children and adolescents.