Dural Penetration of Cavernous Hemangioma on Skull: Uncommon Clinical Presentation

BACKGROUND: Cavernous hemangioma (CH) of the bone is a rare, benign neoplasm found usually in the vertebral body. This tumor rarely develops in the calvaria, with predilection to occur in the frontal and temporoparietal bones. CASE DESCRIPTION: A 56-year-old man with a right frontal palpable mass was admitted to our hospital. Magnetic resonance imaging (MRI) revealed a large extra-axial tumor in the right frontal bone. Intraoperatively, the bony mass involved the multilayers composed of extracranium-skull-dura-intradura-cortex. Pathologic examination revealed a typical calvarial CH penetrating dura mater. CONCLUSIONS: This is the second reported case of calvarial CH with complete erosion of the dural plane and extension into subdural space. Although surgical resection is generally safe and easy, the possibility of dural invasion should be kept in mind for safe resection of calvarial CH, especially overlying the eloquent brain area.