The most commonly involved site of intraosseus hemangiomas is the vertebrae, and hemangiomas of the calvarial bones account for 0.2 percent of all bone neoplasms [
1,
3]. Women are two times more commonly afflicted than are men and the peak age incidence is the fourth decade [
4], although pediatric cases are described [
5]. The frontal bones are the most commonly affected, followed by the parietal bones [
3]. A skull hemangioma occurring at the site of a cranioplasty was described [
6]. The great majority of reported cases of hemangiomas are unifocal but multiple hemangiomas have been reported [
4]. Trauma seems not to be a predisposing factor in the development of these lesions. Hemangiomas may be the result of faulty differentiation of primordial vessels, resulting in an abnormal capillary bed. Hemangiomas have been classified as cavernous, that is predominant in hemangiomas of the skull, capillary, or venous [
7]. In most calvarial hemangiomas, the inner table remains intact, allowing
en bloc resection. Plain radiography or CT scan reveals this lesion as solitary lytic lesions with a sclerotic rim while MRI shows isointense on T1-weighted images and hyperintense on T2-weighted images, consistent with regions of slow-flowing blood. Sometimes, the classic radiographic appearances are not evident. Consequently, the diagnosis is most often made during surgical resection. These tumors can be misinterpreted as lesions like multiple myeloma or osteosarcoma [
8]. The first report of a primary hemangioma of the skull was by Toynbee [
9] in 1845 and the most important review was published by Heckl [
3] in 2002 regarding 103 histologically proven cases between 1975 and 2000. The gold standard treatment is
en bloc resection of the tumor with the removal of a rim of normal bone, described in 1923 by Cushing [
10]. Instead, radiotherapy should be reserved for those few cases that are not safely resectable [
11]. Cases of recurrence of this lesion after complete resection have not been described.