Authors reported an autopsy case of
extracerebral cavernous hemangioma in the middle fossa and discussed the effect of irradiation
therapy on it. A 72-year-old woman was admitted due to progressive deterioration of consciousness and the right
hemiparesis. CT scan revealed a slightly high density mass, which was markedly heterogeneously enhanced with
contrast media, in the left middle cranial fossa. Angiogram with prolonged injection demonstrated a faint
tumor stain.
Craniectomy and partial temporal lobectomy for
decompression were performed, but the
tumor could not be removed due to uncontrollable
hemorrhage. Her level of consciousness further deteriorated, and in addition
heart failure developed. And finally she became vegetative in spite of effective irradiation
therapy of 46Gy. CT scan taken three months and seven years after the irradiation showed marked regression of the
tumor. After the
vegetative state for 8 years, the patient died of
acute pancreatitis, and autopsy was performed. The
cavernous hemangioma with markedly proliferated interstitial connective tissue and thrombosed vessels was verified by microscopical examination. Although the treatment was not successful in this patient, we confirmed that irradiation is useful in the management of the extra-axial
cavernous hemangioma in the middle fossa as a pre- or postoperative adjunct
therapy.