Solid Cerebellar Hemangioblastoma with Peritumoral Edema: 5-Years Follow up

Hwang, Kyoung Jin; Song, Soo Jin; Park, Key‐Chung; Yoon, Sung Sang; Ahn, Tae-Beom

doi:10.13104/imri.2015.19.4.248

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…In gadolinium-enhanced MRI, the nodule has prominent enhancement (Ho et al 1992 ). Since MRI findings for solid hemangioblastomas are similar to those in the present case, it was hard to make a definite diagnosis based on imaging (Hwang et al 2015 ). Angiographical findings for hemangioblastoma often include enlarged feeding arteries and dilated draining veins with dense tumor staining (Ho et al 1992 ; Hwang et al 2015 ).…”

Section: Discussion and Evaluationsupporting

confidence: 57%

“…Since MRI findings for solid hemangioblastomas are similar to those in the present case, it was hard to make a definite diagnosis based on imaging (Hwang et al 2015 ). Angiographical findings for hemangioblastoma often include enlarged feeding arteries and dilated draining veins with dense tumor staining (Ho et al 1992 ; Hwang et al 2015 ). Angiography in the present case showed a hypervascular mass stain with a feeding artery, a draining vein and an arteriovenous shunt that were also very similar to the common findings in hemangioblastoma, and distinguishing between these tumors was difficult.…”

Section: Discussion and Evaluationsupporting

confidence: 57%

See 1 more Smart Citation

Metastatic cerebellar tumor of papillary thyroid carcinoma mimicking cerebellar hemangioblastoma

Ideguchi

Nishizaki²,

Ikeda³

et al. 2016

SpringerPlus

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IntroductionWell-differentiated papillary thyroid carcinoma generally (PTC) have a favorable prognosis. This metastasis is rare in the central nervous system. Brain metastasis has a relatively poor prognosis. We present a rare case of cerebellar metastasis, one that mimics a solid type cerebellar hemangioblastoma and because of which it was very hard to reach accurate preoperative diagnosis. Accurate diagnosis was challenging because of the similar imaging and histopathological findings for these two tumors.Case descriptionA brain lesion was detected by routine medical checkup of the brain with MRI in a 49-year-old woman 2 years after thyroidectomy for well-differentiated PTC. Gadolinium-enhanced MRI showed a homogeneous prominently enhanced lesion with surrounding enhanced dilated vessels in the left cerebellar hemisphere. Digital subtraction angiography showed a strongly stained lesion fed by the peripheral branch of the left posterior inferior cerebellar artery with drainage into the inferior vermian vein, revealing arteriovenous shunting. The most like likely preoperative diagnosis was felt to be that of a solid cerebellar hemangioblastoma. Gross total resection of the tumor was achieved by bilateral suboccipital craniotomy, and intraoperative pathological analysis suggested hemangioblastoma. Histopathological findings showed proliferation of vacuolated sheeted tumor cells with clear and eosinophilic cytoplasm and numerous thin-walled microvessels, consistent with hemangioblastoma. However, the final diagnosis was brain metastasis of the follicular variant of PTC due to a partial thyroid follicle-like pattern including eosinophilic fluid pathologically and positive TTF-1 immunostaining.Discussion and evaluationSince presented rare case of cerebellar metastasis of PTC was very similar to solid type cerebellar hemangioblastoma on imaging and histopathological findings, accurate diagnosis was challenging. Moreover, it is extremely rare for a cerebellar metastasis to occur as an initial distant metastasis of PTC, and hemangioblastoma is the most common primary cerebellar neoplasm in adults. This epidemiological data was also one of the reason of difficulty to reach preoperative accurate diagnosis.ConclusionsTo the best of our knowledge, there are no other reports of challenging diagnosis case of these two tumors in the literature. Brain metastasis of a well-differentiated PTC could be a relatively poor prognostic factor, and accurate diagnosis and suitable surgical therapy or radiotherapy are needed.

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Section: Discussion and Evaluationsupporting

confidence: 57%

Section: Discussion and Evaluationsupporting

confidence: 57%