Suprasellar Hemangioblastoma with Reversible Edema-Like Change Along the Optic Tract: A Case Report and Literature Review

World Neurosurg. 2018 Jun:114:187-193. doi: 10.1016/j.wneu.2018.03.114. Epub 2018 Mar 23.

Abstract

Background: Hemangioblastomas usually occur in the cerebellum and are often a component of von Hippel-Lindau disease. Edema-like changes along the optic tract are commonly observed in association with tumors in the sellar and suprasellar regions, such as craniopharyngiomas and pituitary adenomas. Here, we describe a case of sporadic suprasellar hemangioblastoma with edema-like changes along the optic tract that completely resolved after surgery.

Case description: The patient was a 28-year-old woman with failing vision and a bitemporal hemianopia. Magnetic resonance imaging revealed a tumor accompanied by a 10-mm cyst. Fluid-attenuated inversion recovery axial magnetic resonance imaging revealed a hyperintense region along the optic tract. Other regions of the central nervous system were normal. Endoscopic transsphenoidal surgery was performed, and the histopathologic findings confirmed hemangioblastoma. Six months after surgery, the edema-like change along the optic tract had disappeared. The patient is doing well without pituitary insufficiency, pituitary hormone medications, or signs of tumor recurrence. In addition, the genetic test was negative for von Hippel-Lindau mutations.

Conclusions: When examining a patient with suprasellar tumor, clinicians must consider the possibility of hemangioblastoma. Adequate treatment can improve the edematous change and visual disturbance.

Keywords: Edema-like change along the optic tract; Suprasellar hemangioblastoma; Transsphenoidal surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brain Edema / complications
  • Brain Edema / diagnostic imaging*
  • Brain Edema / surgery
  • Cerebellar Neoplasms / complications
  • Cerebellar Neoplasms / diagnostic imaging*
  • Cerebellar Neoplasms / surgery
  • Female
  • Hemangioblastoma / complications
  • Hemangioblastoma / diagnostic imaging*
  • Hemangioblastoma / surgery
  • Humans
  • Optic Tract / diagnostic imaging*
  • Optic Tract / surgery