Objectives

The histological spectrum of hemangiomas of the skull base and maxillofacial skeleton was evaluated to help explain the variability of the clinical and radiological presentation of this tumor.

Design

Retrospective case series.

Participants

Patients with surgically treated hemangiomas of the ear, sinuses, skull base, and maxillofacial bones.

Method

Light microscopic appearance of surgical specimens.

Results

Review of specimens from 23 tumors revealed two distinct histological patterns: 1) typical histology consisting of vascular spaces lined by endothelium and a thin layer of smooth muscle, and 2) osteofibrous histology that consisted of prominent fibrous tissue between vascular spaces associated occasionally with neo-osseogenesis. The osteofibrous histology was more prevalent in the sinonasal and anterior skull base regions compared to the internal auditory canal.

Conclusions

Connective tissue and bony proliferation within hemangiomas vary according to tumor location and may have implications for the radiological appearance, ease of surgical resection, and associated morbidity.