Fronto-orbital intraosseous hemangioma with skull base erosion: When a relative “simple” disease could require a “complex” approach

Osseous hemangiomas are rare benign vascular bone tumors usually involving skull bones. Sometimes it is difficult to exclude a malignant tumor, since they are vascularized lesions associated with bone erosion and to perform an incisional biopsy in some cases can be challenging for the risk of bleeding. We present a case of osseous hemangioma involving fronto-orbital region associated with dura mater exposure by extensive anterior cranial fossa erosion, that underwent radical surgical excision after pre-operative sclerotization. CAD/CAM technology reconstruction permitted to guarantee an adequate aesthetic-functional result and to reduce operative time. •Osseous hemangiomas are rare and often involving skull bones.•Differential diagnosis with a malignant tumor may be difficult due to presentation as vascularized lesions with bone erosion.•Performing an incisional biopsy in some cases can be challenging for the risk of haemorrhage.•Localisation may play a crucial role in prognosis and therapeutic planning.•CAD/CAM technology permit to reduce operative time and to guarantee an adeguate aesthetic-functional result.