Ossified and de novo cavernous malformations in the same patient

We report the case of a 44-year-old patient with a MRI scan showing a newly developed cavernoma after two highly calcified lesions had been excised surgically. Six other cavernous malformations had been followed by MR imaging over a 2-year period. The coexistence of the two extremes of cavernous malformations in terms of lesions development—de novo and ossified lesions—has not been reported previously and has implications for both the follow-up and the natural history of these malformations. The potential for developing new cavernous malformations persists and does not seem to be related to the evolutional stage of pre-existing lesions. It is suggested that these patients need to be followed up by MRI on a regular basis.