Neurosurgery. Neurology. Surgical Aproach Brain Tumors. Solid Supratentorial Hemangioblastoma not Associated with Von Hippel Lindau Disease Hemangioblastoma

1. Name: Dr. Damian Lastra Copello
Medical University of Havana. Cuba
Topic Presentattion
Solid Supratentorial Hemangioblastoma not
associated with Von Hippel Lindau disease:
Clinical case
damianlastra2@gmail.com

3. Solid Supratentorial Hemangioblastoma not
associated with Von Hippel Lindau disease:
Clinical case
Dr. Damian Lastra Copello
Consultant Neurosurgeon, Diploma in Emergency and Intensive Care,
Christmas International Brain and Spine Surgery Center, Addis Ababa
Ethiopia.
Dr. Yohana Camejo Sánchez
Consultant Neurosurgeon, Comprehensive General Medicine Specialist.
Diploma in Emergency and Intensive Care, Christmas International Brain
and Spine Surgery Center, Addis Ababa Ethiopia.

5. Brain Hemangioblastoma
 It is a rare neoplastic entity of the Central Nervous
System.
 On 2016, classification for CNS tumors of WHO
classifies this type of lesion as a non-meningothelial
mesenchymal tumor grade 1.
 It is a highly vascularized lesion, whose most frequent
differential diagnosis is Arteriovenous Malformations
and lesions with cystic component in a large number of
cases confirmed by Scientific publications.

6.  Frequently associated with Von Hippel Lindau disease
 These lesions are commonly located in the posterior
fossa, they constitute 2% of all intracranial tumors.
 They preferentially affect the cerebellum, spinal cord,
and brainstem.
 Its location in the supratentorial space is less than
0.5% of the cases reported.

7. The location of these lesions in the
supratentorial space in their solid form,
not associated with VHL disease, is
extremely rare; cases with these
characteristics have not been frequently
reported, at least in the publications on
the subject during the last decade. .

8.  We present the case of a 51-year-old patient with a
history of high blood pressure with regular
treatment.
 Was treated in our center for presented symptoms
of loss of consciousness for approximately 40 min
and involuntary movement. (Generalized tonic
clonic seizures)
 Initially received in the ICU service, where was
performed Intensive Treatment with the objective
of preserve his live getting recovery his state
concious

9.  Neuroimaging studies were performed in
order to establish a definitive diagnosis in
the patient.
 Brain Contrast CT Scan
 Brain Contrast MRI

10. The contrast Brain CT Scan study reports the presence of a
conglomerate of vessels on right temporal, parietal and occpital
region measuring 5.7 x 5 cm that is nourished by the branches
of the right middle cerebral artery, associated with brain edema
that collapses and displaces the ventricular system to the left 1
cm.

11. 1.2 Contrast Brain CT Scan

12. CONTRAST BRAIN
MRI

14. Reconstruction of Contrasted Brain
CT Scan study.

17. Posterior parietal craneotomy was performed
with the aim of obtaining biopsy and achieving a
maximum safe resection of the tumor
(50% of the lession was removed)

19. Microscopic study
 Cytoplasm cells loaded with lipids that form
the stroma
 Capillary vessels without nervous tissue
filed
 Mast cells

20.  . Other imaging studies were performed during the
postoperative period :
 • Abdominal Ultrasound (USD)
 • Lung CT
 • MRI of the Spine
 A fundus eye examination was performed

23. Post-surgical status of the patient at 72
hours.
• Sensory dysphasia
• No motor deficit
• Glasgow Coma Scale 14/15 points

24. The final diagnosis was determined by
biopsy, Image study and clinical
correlation as solid supratentorial
hemangioblastoma not associated with
VHL

25.  What we know is a drop of water, what we ignore is the
ocean.
Isaac Newton.

26. THANKS .