J Korean Neurosurg Soc.  2015 Jun;57(6):465-468. 10.3340/jkns.2015.57.6.465.

Sporadic Hemangioblastoma in the Pituitary Stalk: A Case Report and Review of the Literature

• Lee GI
• Kim JM
• Choi KS
• Kim CH

• KMID: 2191256
• DOI: http://doi.org/10.3340/jkns.2015.57.6.465

Abstract

Hemangioblastomas in the pituitary stalk are especially rare. Most pituitary stalk hemangioblastomas reported in the literature were associated with von Hippel-Lindau (VHL) disease. Here, we report only the 3rd case of sporadic pituitary stalk hemangioblastoma diagnosed in a 60-year-old woman. Despite the danger of potential complications due to excessive vascularity or proximity to important neural structures, the tumor in our case was successfully removed while preserving pituitary function. In this case, complete surgical excision was shown to be an effective treatment option for symptomatic pituitary stalk hemangioblastoma, and we suggest careful evaluation of any highly enhancing mass with a signal void in the pituitary stalk preoperatively, even if no VHL disease is evident.

Keyword

Hemangioblastoma; Pituitary stalk; Suprasellar tumor

MeSH Terms

Female
Hemangioblastoma*
Humans
Middle Aged
Pituitary Gland*

Figure

• 

  Fig. 1 Preoperative sagittal T1-weighted magnetic resonance image without contrast enhancement reveals an isointense suprasellar mass 10 to 12 mm in dimension located on the pituitary stalk (A). Preoperative sagittal and coronal magnetic resonance images with contrast show strongly enhanced mass involving the pituitary stalk (white arrow) with multiple signal voids inside (black arrows) (B and C).

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  Fig. 2 Intraoperative photograph shows a hyperemic, round mass with a thin capsule (white arrow) (A). The paper thin leafs of the pituitary stalk (asterisk) is revealed after total removal of tumor mass (B).

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  Fig. 3 Photomicrographic view of the tumor specimens showing a vascular lesion composed of prominent thin-walled vessels with vacuolated stromal cells (Hematoxylin and eosin, ×50) (A). Blue circles indicate positively stained endothelial cells (Immunostain for CD34 stain, ×200) (B).

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  Fig. 4 The sagittal (A) and coronal (B) brain magnetic resonance images with contrast which obtained 6 months after complete removal of the tumor demonstrate an intact pituitary stalk and no residual tumor.

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