Masuda A, Fujioka M
Department of Neurosurgery, Nara Prefectural Mimuro Hospital.
No Shinkei Geka. 1996 Oct;24(10):949-53.
Cystic hemangioblastoma of the brain stem is an extremely rare clinical entity. Only eight cases have been reported in the literature. This is a report of a case of successful extirpation of a cystic hemangioblastoma of the medulla oblongata. A 47-year-old man was admitted to our clinic with the complaint of progressive numbness on his left upper limb since January 1995. Neurological examination revealed numbness and decreased vibration sensation on his left upper limb. MRI showed a cystic 1.5 x 2.0 cm lesion on the medulla oblongata, and with administration of Gd-DTPA, a small mass lesion on the dorsolateral side of the medulla oblongata. Left vertebral angiogram revealed a tumor fed directly from the left vertebral artery. An operation was performed using a suboccipital approach. The dorsal surface of the medulla was swollen edematously, suggesting the site of a cyst, which emptied by means of opening the wall. The reddish tumor was embedded on the left dorsolateral surface of the medulla oblongate. A total extirpation of the tumor was carried out under microscopic procedure. Histologically, the tumor was diagnosed as a hemangioblastoma. The patient was free from his distressing numbness immediately after the operation, and discharged without neurological deficit.