Suprasellar Hemangioblastoma during Pregnancy: Case Report
Notice bibliographique
Résumé
Background: Hemangioblastoma is a benign tumor that typically occurs in the posterior fossa, but may be found in anywhere along the neuraxis, including the parasellar and suprasellar region. Suprasellar hemangioblastoma is a rare entity that represents a unique management challenge. Pregnancy is a possible promoter of hemangioblastoma growth and has been investigated in recent years. We present the case of a 30-year-old pregnant woman with a hemangioblastoma of the suprasellar region managed with stereotactic radiation therapy following delivery. Case Description: A 30-year-old female presented at 35-weeks of gestation with a one-month history of gradually progressive bitemporal hemianopsia, headache, impulsiveness, and short-term memory decline. Magnetic resonance imaging (MRI) showed a solid, 3.3 × 3.0 × 3.5 cm lesion in the suprasellar region with post-gadolinium T1 weighted imaging demonstrating avid enhancement of the mass. The patient was admitted to hospital for investigation, and within days, her vision deteriorated to only light perception in the right eye and counting fingers in the left. Because of her rapidly progressive symptoms, the baby was delivered by cesarean prior to neurosurgical intervention. The patient underwent bifrontal craniotomy and bilateral orbital osteotomy for attempted resection of the lesion. Because of excessive bleeding from the tumor, resection was abandoned and the procedure was limited to a biopsy, which demonstrated hemangioblastoma. The patient was subsequently treated with stereotactic radiotherapy (SRT) for residual tumor to a total dose of 5,400 cGy, given in 1.8 Gy fractions over 6 weeks. Outcome: Six months after her initial presentation, and three months following the completion of SRT, the patient’s vision had returned to normal. At presentation, mini-mental status examination revealed significant deficits in memory and concentration; however, at 5 months post-SRT, detailed neuropsychological assessments revealed only very subtle deficits, suggesting considerable improvements in cognition. Five years after the conclusion of her course of radiotherapy, the patient’s scan showed a residual suprasellar lesion measured at 1.6 × 1.5 × 1.4 cm. Discussion: Suprasellar hemangioblastomas are exceedingly rare. No reported cases arose in pregnancy. Most demonstrate solid, often large, highly vascularized tumors that show prominent flow voids on MRI. Hemorrhage can complicate resection, limiting surgical intervention. Because of the limited data available in the literature, it is difficult to ascertain the rate of success following radiotherapy (RT) for hemangioblastomas in the suprasellar region. Three cases identified in the literature describe suprasellar hemangioblastomas in which total resection was not performed, and RT resulted in good outcomes for all three cases. In addition to the present case, these emphasize the utility of RT in the management of suprasellar hemangioblastomas. Conclusion: High vascularity and solid growth with a tendency for surgical complications appear typical of suprasellar hemangioblastoma, as indicated by this and several other reported cases. The importance of nonsurgical treatment strategies, including radiation therapy, is emphasized by this case. Pregnancy is one of the factors that has been investigated as potentially growth promoting. We speculate that postpartum hormonal changes may have contributed to tumor shrinkage in our case. Publication History Article published online: 07 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,004 | 0,002 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,008 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».