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Published in: Journal of Medical Case Reports 1/2011

Open Access 01-12-2011 | Case report

Manifestation of a sellar hemangioblastoma due to pituitary apoplexy: a case report

Authors: Ralph T Schär, Istvan Vajtai, Rahel Sahli, Rolf W Seiler

Published in: Journal of Medical Case Reports | Issue 1/2011

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Abstract

Introduction

Hemangioblastomas are rare, benign tumors occurring in any part of the nervous system. Most are found as sporadic tumors in the cerebellum or spinal cord. However, these neoplasms are also associated with von Hippel-Lindau disease. We report a rare case of a sporadic sellar hemangioblastoma that became symptomatic due to pituitary apoplexy.

Case presentation

An 80-year-old, otherwise healthy Caucasian woman presented to our facility with severe headache attacks, hypocortisolism and blurred vision. A magnetic resonance imaging scan showed an acute hemorrhage of a known, stable and asymptomatic sellar mass lesion with chiasmatic compression accounting for our patient's acute visual impairment. The tumor was resected by a transnasal, transsphenoidal approach and histological examination revealed a capillary hemangioblastoma (World Health Organization grade I). Our patient recovered well and substitutional therapy was started for panhypopituitarism. A follow-up magnetic resonance imaging scan performed 16 months postoperatively showed good chiasmatic decompression with no tumor recurrence.

Conclusions

A review of the literature confirmed supratentorial locations of hemangioblastomas to be very unusual, especially within the sellar region. However, intrasellar hemangioblastoma must be considered in the differential diagnosis of pituitary apoplexy.

Literature
  1. Fomekong E, Hernalsteen D, Godfraind C, D'Haens J, Raftopoulos C: Pituitary stalk hemangioblastoma: the fourth case report and review of the literature. Clin Neurol Neurosurg. 2007, 109: 292-298. 10.1016/j.clineuro.2006.11.007.View ArticlePubMed
  2. Neumann HP, Eggert HR, Weigel K, Friedburg H, Wiestler OD, Schollmeyer P: Hemangioblastomas of the central nervous system. A 10-year study with special reference to von Hippel-Lindau syndrome. J Neurosurg. 1989, 70: 24-30. 10.3171/jns.1989.70.1.0024.View ArticlePubMed
  3. Conway JE, Chou D, Clatterbuck RE, Brem H, Long DM, Rigamonti D: Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease. Neurosurgery. 2001, 48: 55-63.PubMed
  4. Wanebo JE, Lonser RR, Glenn GM, Oldfield EH: The natural history of hemangioblastomas of the central nervous system in patients with von Hippel-Lindau disease. J Neurosurg. 2003, 98: 82-94. 10.3171/jns.2003.98.1.0082.View ArticlePubMed
  5. Sherman JH, Le BH, Okonkwo DO, Jane JA: Supratentorial dural-based hemangioblastoma not associated with von Hippel Lindau complex. Acta Neurochir. 2007, 149: 969-972. 10.1007/s00701-007-1180-7.View ArticlePubMed
  6. Sharma RR, Cast IP, O'Brien C: Supratentorial haemangioblastoma not associated with Von Hippel Lindau complex or polycythaemia: case report and literature review. Br J Neurosurg. 1995, 9: 81-84. 10.1080/02688699550041809.View ArticlePubMed
  7. Iplikçioglu AC, Yaradanakul V, Trakya U: Supratentorial haemangioblastoma: appearances on MR imaging. Br J Neurosurg. 1997, 11: 576-578. 10.1080/02688699745772.View ArticlePubMed
  8. Lonser RR, Butman JA, Kiringoda R, Song D, Oldfield EH: Pituitary stalk hemangioblastomas in von Hippel-Lindau disease. J Neurosurg. 2009, 110: 350-353. 10.3171/2008.4.17532.View ArticlePubMedPubMed Central
  9. Niemelä M, Lim YJ, Söderman M, Jääskeläinen J, Lindquist C: Gamma knife radiosurgery in 11 hemangioblastomas. J Neurosurg. 1996, 85: 591-596. 10.3171/jns.1996.85.4.0591.View ArticlePubMed
  10. Miyata S, Mikami T, Minamida Y, Akiyama Y, Houkin K: Suprasellar hemangioblastoma. J Neuroophthalmol. 2008, 28: 325-326.View ArticlePubMed
  11. Sajadi A, de Tribolet N: Unusual locations of hemangioblastomas. Case illustration. J Neurosurg. 2002, 97: 727-10.3171/jns.2002.97.3.0727.View ArticlePubMed
  12. Semple PL, Webb MK, de Villiers JC, Laws ER: Pituitary apoplexy. Neurosurgery. 2005, 56: 65-72.PubMed
  13. Burt MG, Morey AL, Turner JJ, Pell M, Sheehy JP, Ho KK: Xanthomatous pituitary lesions: a report of two cases and review of the literature. Pituitary. 2003, 6: 161-168.View ArticlePubMed
  14. Modan-Moses D, Weintraub M, Meyerovitch J, Segal-Lieberman G, Bielora B: Hypopituitarism in langerhans cell histiocytosis: seven cases and literature review. J Endocrinol Invest. 2001, 24: 612-617.View ArticlePubMed
  15. Rho YM: Von Hippel-Lindau's disease: a report of five cases. Can Med Assoc J. 1969, 101: 135-142.PubMedPubMed Central
  16. Dan NG, Smith DE: Pituitary hemangioblastoma in a patient with von Hippel-Lindau disease. Case report. J Neurosurg. 1975, 42: 232-235. 10.3171/jns.1975.42.2.0232.View ArticlePubMed
  17. O'Reilly GV, Rumbaugh CL, Bowens M, Kido DK, Naheedy MH: Supratentorial haemangioblastoma: the diagnostic roles of computed tomography and angiography. Clin Radiol. 1981, 32: 389-392. 10.1016/S0009-9260(81)80276-0.View ArticlePubMed
  18. Grisoli F, Gambarelli D, Raybaud C, Guibout M, Leclercq T: Suprasellar hemangioblastoma. Surg Neurol. 1984, 22: 257-262. 10.1016/0090-3019(84)90010-7.View ArticlePubMed
  19. Sawin PD, Follett KA, Wen BC, Laws ER: Symptomatic intrasellar hemangioblastoma in a child treated with subtotal resection and adjuvant radiosurgery. Case report. J Neurosurg. 1996, 84: 1046-1050. 10.3171/jns.1996.84.6.1046.View ArticlePubMed
  20. Kachhara R, Nair S, Radhakrishnan VV: Sellar-sphenoid sinus hemangioblastoma: case report. Surg Neurol. 1998, 50: 461-463. 10.1016/S0090-3019(97)00197-3.View ArticlePubMed
  21. Kouri JG, Chen MY, Watson JC, Oldfield EH: Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases. J Neurosurg. 2000, 92: 1028-1035. 10.3171/jns.2000.92.6.1028.View ArticlePubMed
  22. Goto T, Nishi T, Kunitoku N, Yamamoto K, Kitamura I, Takeshima H, Kochi M, Nakazato Y, Kuratsu J, Ushio Y: Suprasellar hemangioblastoma in a patient with von Hippel-Lindau disease confirmed by germline mutation study: case report and review of the literature. Surg Neurol. 2001, 56: 22-26. 10.1016/S0090-3019(01)00482-7.View ArticlePubMed
  23. Ikeda M, Asada M, Yamashita H, Ishikawa A, Tamaki N: A case of suprasellar hemangioblastoma with thoracic meningioma. No Shinkei Geka. 2001, 29: 679-683.PubMed
  24. Rumboldt Z, Gnjidic Z, Talan-Hranilovic J, Vrkljan M: Intrasellar hemangioblastoma: characteristic prominent vessels on MR imaging. AJR Am J Roentgenol. 2003, 180: 1480-1481.View ArticlePubMed
  25. Wasenko JJ, Rodziewicz GS: Suprasellar hemangioblastoma in Von Hippel-Lindau disease: a case report. Clin Imaging. 2003, 27: 18-22. 10.1016/S0899-7071(02)00537-5.View ArticlePubMed
  26. Peker S, Kurtkaya-Yapicier O, Sun I, Sav A, Pamir MN: Suprasellar haemangioblastoma. Report of two cases and review of the literature. J Clin Neurosci. 2005, 12: 85-89. 10.1016/j.jocn.2004.02.025.View ArticlePubMed
  27. Miyata S, Mikami T, Minamida Y, Akiyama Y, Houkin K: Suprasellar hemangioblastoma. J Neuroophthalmol. 2008, 28: 325-326.View ArticlePubMed
Metadata
Title
Manifestation of a sellar hemangioblastoma due to pituitary apoplexy: a case report
Authors
Ralph T Schär
Istvan Vajtai
Rahel Sahli
Rolf W Seiler
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-5-496

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