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Washington University Experience | NEOPLASMS (MESENCHYMAL, NON-MENINGOTHELIAL) | Hemangioblastoma | 10C Denoument Case 10 - Copy
Denouement ---- Extensive subarachnoid spread of hemangioblastoma is extremely rare with two cases reported at the time of this case. The absence of recurrent tumor at the operative site suggests that the process had already spread through the meninges at the time of the initial operation. Although the nuclear pleomorphism is striking in this case, tumor giant cells and variation in nuclear size are frequently seen in usual non-aggressive HAB. In addition, the total absence of mitotic activity in this case is notable. The only strong histologic evidence of the malignant nature of this tumor is the parenchymal invasion in the spinal cord, brainstem, and most impressively, the floor of the third ventricle. ---- Secondary effects of the tumor included nerve compression, which resulted in histologically identifiable fiber loss primarily in the dorsal roots of the spinal cord. Ischemic damage secondary to vascular compromise could not be confirmed. The general autopsy findings include those of atherosclerosis and hypertension, but none of the associated lesions of Von-Hippel-Lindau disease.
