Findings
Axial, coronal reformatted CT sections of the brain reveal a focal lytic expansile lesion in the left frontal bone with radiating bone spicules, destruction of the inner and outer tables. No periosteal reaction or associated soft tissue noted. The lesion was seen indenting adjacent left frontal lobe brain parenchyma with no edema.
Diagnosis
Intraosseous calvarial venous malformation
Summary
- Calvarial intraosseous venous malformations, inaccurately called hemangiomas, are nonneo-
plastic low-flow venous malformations of the skull. - They are considered to be congenital and are seen mainly in persons in their 4th and 5th
decades of life. - They occur most commonly in the frontal bones, followed by the parietal and temporal bones.
- At radiography and CT, they appear as osteolytic, expansile lesions and typically display a honeycomb or sunburst appearance owing to radiating bone spicules.
- They appear as mixed hyperintensity (fatty tissue) and hypointensity (iron) at T1-weighted MRI, hyperintensity at T2-weighted MRI owing to slow flow or pooling of blood, and heterogeneous post-contrast enhancement.
Further reads
Khodarahmi, I., Alizai, H., Chalian, M., Alaia, E. F., Burke, C. J., Slasky, S. E., & Wenokor, C. (2021). Imaging Spectrum of Calvarial Abnormalities. Radiographics : a review publication of the Radiological Society of North America, Inc, 41(4), 1144–1163. https://doi.org/10.1148/rg.2021200198
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