Atypical Presentation of Parietal Convexity Dural-Based Cavernous Hemangioma: A Case Report and Review of Literature.

Abstract

Dural presentation of a cavernous hemangioma is a rare occurrence. Classically an intraparenchymal lesion with varying symptomatology including mostly headaches, seizures, and neurologic deficits depending on its location, a few cases have been reported along the convexity of the brain, even less eroding the calvaria, with none occasioning abnormal movements as the initial presentation. This is a case of a 67-year-old male who presented to the clinic for atypical progressive choreiform movements of the right side of his body and a soft subgaleal mass. Radiographic imaging showed a parietal tumor with intradural and extradural invasion mimicking a meningioma, which does not provide, given its location, a clear explanation of the symptoms. A craniotomy was performed on 29 January, 2018, during which the tumor was resected along with the invaded dura mater and calvaria. A pathology report was positive for cavernous hemangioma, an unexpected diagnosis based on the tumor's characteristics. After surgery, the patient recovered completely without residual symptoms, suggesting a compressive mass effect causing the atypical movement disorders.