We report the case of a 52-year-old woman with no relevant past medical history who was referred to our Department for surgical evaluation.
Four years ago he had a small tumor in the right side of the forehead, which had slowly increased in size.
During exploration, a hard, painless, non-mobilizing mass was found under normal skin.
Plain radiography and head CT showed a right frontal intraosseous lesion with osteolytic characteristics.
The radiological differential diagnosis included metastases, myeloma and hemangioma.
Systemic tumor screening studies (BCS), hematological smears, tumor markers, proteinogram and cervico-thoraco-abdominal TAC) were negative.
Bone scintigraphy with CDP-Tc99M revealed a rounded deposit in the lesion area.
Percutaneous needle aspiration biopsy of the tumor was inconclusive for the diagnosis, since only fragments were identified.
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Finally, it was decided to surgically intervene the patient based on the clinical progression of the lesion, with its aesthetic implications, as well as to obtain a definitive histological diagnosis.
During surgery, a bone-dependent tumor was identified, with multiple vascular channels spread within it, which expanded the external table.
To avoid manipulation of the lesion, it was decided to include it in a craniectomy specimen with a circumferential margin of 1 cm of apparently healthy bone.
The resulting bone defect was fixed to the surrounding bone using a Methylmethacrylate cranioplasty with mini-plates.
The postoperative period was uneventful.
Definitive pathological diagnosis was intraosseous cavernous hemangioma.
