Subcutaneous cavernous hemangioma of the temporal region of the head: rare case report

Background: The cavernous hemangioma is considered by the World Health Organization a benign vascular tumor that more frequently afflicts the superficial skin, however it can develop in any part of the body. Despite the several locations described for this type of tumor, there is not a single case presented in the literature of a subcutaneous tissue cavernous hemangioma of the temporal region of the head.

Objective: The authors report a case of a subcutaneous cavernous hemangioma of temporal region and review the literature the epidemiological, clinical, pathological and treatment features.

Casuistic and Methods: This study was performed from a documentary research based on data provided from the medical records and complementary exams of the patient. Furthermore, a bibliographical search was performed using the indexed databases, utilizing language as selection criteria, choosing preferably recent articles in Portuguese, Spanish or English.

Clinical Presentation: Female patient, 80-years-old, experienced subtle headache associated with progressive right temporal region growing mass and right moderate otalgia. During the following 25 days after initial presentation, the otalgia and right temporal headache had worsened, as well as the temporal region mass had an important growth in size, which presented with worsened pain on superficial touching, unresponsive to conventional analgesia. The patient underwent gross total microsurgical resection of the tumor without complications or presence of any neurological deficits.

Discussion: Hemangiomas are benign vascular malformations of congenital origin that are characterized by vessels proliferation. The progression and malignancy are not often seen in this tumor, although the etiology remain unclear until the moment. Histologicaly classified as cavernous and capillary, the cavernous hemangiomas have been not described commonly in the literature and they incidence in subcutaneous of head are extremaly rare (< 10% of hemangiomas). Clinical features depend exclusively on its topography, size of the lesion and presence of acute bleeding. The embolization or surgical resection are adopted as treatment with an adequate prognosis in long term.

Conclusion: The cavernous hemangioma of the subcutaneous tissue of the temporal region of the head are rare entities. They should be promptly resected when symptomatic or when rapid growth or unacceptable cosmetic appearance are observed.