Suprasellar Hemangioblastoma during Pregnancy: Case Report
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.006 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".