Intracerebral cavernous hemangiomas are relatively easy to remove surgically, but
extracerebral cavernous hemangiomas attached to the cavernous sinus are extremely difficult to treat. The authors report three cases of
extracerebral cavernous hemangioma in the middle fossa that were treated with
radiotherapy. The follow-up studies with serial computerized tomography (CT) scans during and after irradiation are described. In Case 1
radiotherapy after partial removal of the
tumor decreased the
tumor size on the contrast-enhanced CT scans, reduced its Hounsfield units on the nonenhanced CT scans, and facilitated later total
tumor removal. In Case 2 the
tumor responded to irradiation with approximately 3000 rads, showing significant reduction in size and Hounsfield units of the
tumor. Subtotal removal was then possible. In Case 3 the
tumor responded to irradiation, and the patient's
vertigo improved after delivery of approximately 3000 rads. The CT scan showed significant reduction in the size and Hounsfield units of the
tumor. No surgical intervention was deemed necessary. It is concluded that, in cases of
extracerebral cavernous hemangioma with massive
hemorrhage, irradiation with up to 3000 rads may be the treatment of choice.
Radiation therapy offers an increased probability of total removal of the
tumor and the possibility of eliminating surgery.