Introduction: Cavernous sinus hemangiomas are rare benign vascular malformations presenting a diagnostic challenge and often confused with other, more common parasellar tumors. Making the correct diagnosis preoperatively is essential as surgical resection carries a high risk of intraoperative bleeding.

Clinical presentation usually include ptosis or trigeminal neuralgia due to compression on the cranial nerves passing through the cavernous sinus as well as visual impairment.

Aims: An uncommon case of cavernous sinus hemangioma is presented. We aim to demonstrate the typical imaging findings, differential diagnosis and management of the lesion.

Methods: Our patient presented with headache and no evidence of cranial neuropathy. Physical and neurological examinations were normal.

Contrast enhanced magnetic resonance imaging (MRI) and non-enhanced computed tomography (CT) examinations were performed.

Result: MRI of the brain demonstrated a right parasellar extra-axial mass with markedly high signal intensity on T2 weighted images. Gadolinium-enhanced T1 weighted images initially showed heterogeneous enhancement followed by an intense homogenous filling in on the latephase contrast-enhanced sequence. Non-enhanced CT demonstrated a slightly hyperdense mass extending mildly into the superior orbital fissure with smooth remodeling of the adjacent sphenoid sinus wall. No optic nerve or internal carotid artery compression was detectable.

Conclusion: Cavernous sinus hemangiomas are uncommon benign vascular masses that can be easily confused with other pathologies of the region. However, preoperative diagnosis is of key importance to prevent potentially severe intraoperative bleeding. In the case of an atypical cavernous sinus mass with heterogeneous enhancement, a late-phase or dynamic study could help in the differential diagnosis.

Funding: The authors have no conflict of interest to declare.