RESUMO
Massive hemorrhage is a very uncommon event among hemangioblastomas. Forty-four cases have been reported before this review. Thorough analysis of all reported cases on literature was accomplished. The majority presented as parenchymatous or subarachnoid bleedings. Subarachnoid hemorrhage was only associated with spinal hemangioblastomas, while parenchymatous bleedings were more, but not only, originated from cranial instances. Ventricular hemorrhage from a hemangioblastoma was exceptional, with only two previous cases bleeding directly into the ventricular compartment. To our knowledge, the illustrative case is the first one of pure tetraventricular hemorrhage from a hemangioblastoma. When hemangioblastoma bleeding occurs, it is usually the very first clinical presentation of a previously undetected tumor. Solid type, large size, and spinal-radicular locations are more frequently related to hemorrhage. Hemorrhage following hemangioblastoma embolization and the association of this tumor with other bleeding lesions, such as arteriovenous malformations and aneurysms, is also discussed.
Assuntos
Neoplasias Cerebelares/complicações , Hemorragia Cerebral/etiologia , Hemangioblastoma/complicações , Adulto , Fatores Etários , Idade de Início , Idoso , Neoplasias Cerebelares/diagnóstico , Neoplasias Cerebelares/epidemiologia , Neoplasias Cerebelares/patologia , Angiografia Cerebral , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/patologia , Ventrículos Cerebrais/patologia , Progressão da Doença , Embolização Terapêutica/efeitos adversos , Feminino , Hemangioblastoma/diagnóstico , Hemangioblastoma/epidemiologia , Hemangioblastoma/patologia , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/epidemiologia , Hemorragia Subaracnóidea/epidemiologia , Hemorragia Subaracnóidea/etiologia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: The authors report two unusual cases of extraspinal midline lumbosacral lesions that resembled the usual skin markers of occult spina bifida. PATIENTS AND METHODS: The pathological diagnosis of the masses was plexiform neurofibroma and mastocytoma, respectively. RESULTS: Some lesions, as those we are reporting, although occurring at the lumbosacral midline, do not necessarily belong to occult spinal dysraphism, as was initially suspected. Plexiform neurofibroma and skin mastocytoma are very rare indeed in this spinal location. CONCLUSION: The two cases represent an important addition to the differential diagnosis of a congenital dorsal midline mass.