Intraosseous Haemangioma of the Frontal Bone: A Review of Published Cases and Surgical Management

Abstract

Background: Intraosseous haemangioma of the calvarium is a slow-growing diploic vascular lesion, most often frontal, that
reaches the surgeon as a painless, hard swelling of the forehead. Objective: To establish what the published literature will and will not support regarding frequency, preoperative diagnosis, surgical management and recurrence. Methods: Narrative review of published case reports, pooled literature tallies and institutional surgical series. Findings: The commonly quoted figures of 0.2% of bone tumours and 10% of benign skull tumours have no traceable denominator; a counted operative series found haemangioma in 9 of 133 calvarial lesions (7%). Frontal involvement accounted for 44.1% of 93 published skull cases. No recurrence occurred in 16 operated patients at mean follow-up of 76.2 months. Conclusions: The evidence base is case-level. It supports en bloc excision with a small bony margin and immediate reconstruction; it does not support the quoted rarity, sex ratio or embolisation claims.