Objective: Angioleiomyomas are soft tissue tumors with smooth muscle and vascular components. They are extremely rare in intracranial locations and only three cases have been reported in the literature, including one in the cavernous sinus. Furthermore, long-term follow-up after surgery for a tumor at this site has not been described. We report a new case of intracavernous angioleiomyoma with complete surgical removal and no recurrence after 6 years of clinical and radiological follow-up.
Clinical presentation: A 50-year-old patient presented with vertical diplopia resulting from left trochlear nerve palsy. Magnetic resonance examination showed a left intracavernous tumor with hypersignal on T2-weighted images, hyposignal on T1-weighted images, and delayed homogeneous enhancement after gadolinium injection.
Intervention: Surgical treatment was completed by a left pterional approach. There was a clear plane separating the tumor from the vascular and nervous elements of the cavernous sinus. Complete tumor resection was achieved. Diplopia improved after surgery. Follow-up did not reveal any recurrence.
Conclusion: Angioleiomyomas are rare benign tumors with an excellent prognosis after total removal that justifies surgical treatment as the first-line treatment.