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A CT scan further demonstrated an osteolytic and expansile mass within the clivus, with multiple areas of thickened bone trabeculae resembling a \u2018honeycomb pattern\u2019. A trans-sphenoidal surgical biopsy disclosed an intraosseous venous malformation (cavernous type, formerly known as primary intraosseous cavernous haemangioma).<\/jats:p>\n                  <jats:p>At the neuropaediatric multidisciplinary meeting, curative intent in the form of complete surgical resection was deemed difficult to achieve and it was decided to initiate empirical propranolol therapy. After 2 years of treatment, the patient became asymptomatic and the lesion slightly reduced in size. The following year, the lesion remained stable.<\/jats:p>","DOI":"10.1136\/bcr-2025-268579","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:15:17Z","timestamp":1789150517000},"page":"e268579","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intraosseous venous malformation of the clivus"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0185-7078","authenticated-orcid":false,"given":"Adebayo Olusola","family":"Alade","sequence":"first","affiliation":[{"name":"Radiology Department, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Nunes","sequence":"additional","affiliation":[{"name":"Paediatric Neuro-oncology Department, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Mafra","sequence":"additional","affiliation":[{"name":"Pathology Department, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6114-3054","authenticated-orcid":false,"given":"Alexandra","family":"Borges","sequence":"additional","affiliation":[{"name":"Radiology Department, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091111151103000_19.9.e268579.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000259768.59590.5a"},{"key":"2026091111151103000_19.9.e268579.2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198203000-00002"},{"key":"2026091111151103000_19.9.e268579.3","doi-asserted-by":"crossref","first-page":"100628","DOI":"10.1016\/j.tvir.2019.100628","article-title":"Brief Description of ISSVA Classification for Radiologists","volume":"22","author":"Monroe","year":"2019","journal-title":"Tech Vasc Interv Radiol"},{"key":"2026091111151103000_19.9.e268579.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-008-0709-3"},{"key":"2026091111151103000_19.9.e268579.5","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181f95b83"},{"key":"2026091111151103000_19.9.e268579.6","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.nic.2009.06.001","article-title":"Imaging of the central skull base","volume":"19","author":"Borges","year":"2009","journal-title":"Neuroimaging Clin N Am"},{"key":"2026091111151103000_19.9.e268579.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7575"},{"key":"2026091111151103000_19.9.e268579.8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s11060-021-03757-z","article-title":"Primary and radiation induced skull base osteosarcoma: a systematic review of clinical features and treatment outcomes","volume":"153","author":"Bin Alamer","year":"2021","journal-title":"J Neurooncol"},{"key":"2026091111151103000_19.9.e268579.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-004-2532-9"},{"key":"2026091111151103000_19.9.e268579.10","doi-asserted-by":"crossref","unstructured":"Luo Z , Chen W , Shen X , et al . 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