Primary Intraosseus Haemagioma of The Clivus Mimicking Giant Pituitary Macroadenomoa

Primary intraosseous hemangiomas of the skull base are distinctly unusual and extremely rare tumors. We report a case of 55 year female presented with the history of left sided progressive ptosis associated with facial pain and headache. A magnetic resonance imaging demonstrated a large, homogeneously enhancing lesion in sellar and suprasellar region also involving the clivus, cavernous sinus and clivus. A differential diagnosis of giant pituitary macroadenoma and clival chordoma was suspected. She underwent transseptal transshenoidal endoscope assisted decompression of the tumor and on histopathology a diagnosis of primary intraosseus haemagioma was made. Experts dealing with craniofacial pathologies particularly with skull base should be aware of the distinct though rare group of cavernomas that reside extraaxially and associated with dural or cavernous sinuses.