Objectives: Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson’s tumor, is a benign lesion consisting of a reactive proliferation of endothelial cells with papillary formations related to a thrombus. We report a case of cavernous sinus Masson’s tumor on a 51 year old female, diagnosed after subacute onset of clinical features linked to obstructive hydrocephalus.

Material and methods: A 51 year old woman with a complaint of diplopia, headache and mild cognitive impairment for the prior two months, suspected to have adult chronic hydrocephalus; was referred to our department after a brain MRI revealed a mass ocupying parasellar lesion related to the cavernous sinus. We performed an orbitozygomatic approach in order to grant optic nerve decompression and obtain tissue samples. Despite being earlier reported a meningioma based on radiological studies, the histopathology study reported an IPEH from the cavernous sinus.

Results: After choosing the same management as in an allegedly benign parasellar lesion, we obtained an unlikely histological result (Masson’s tumor). The patient showed an outstanding clinical evolution on a 12 month follow up.

Conclusions: Seldom presentation of IPEH outside the deep dermis makes this case remarkable, even though they may occur in any part of the body. The actual treatment for IPEH is surgical excision with complete resection as it tends to recur if incompletely resected.