Cranial nerve hemangioblastomas. Report of a rare case and review of literature.

BACKGROUND: Cranial nerve hemangioblastomas are exceedingly rare lesions. We review available literature and present the first surgical report on a solid hemangioblastoma arising from the trigeminal nerve and involving the Meckel cave that was successfully treated with selective embolization and successive surgical resection. CASE DESCRIPTION: A 54-year-old woman presented with an 8-month history of facial numbness associated with headache. An MRI revealed a highly vascularized supra- and infratentorial mass involving the right Meckel cave. A preoperative angiogram with selective embolization of tumoral feeders was performed, and the patient elected to undergo surgical treatment. A large solid lesion encasing the trigeminal nerve was resected without complications via a PLPA approach. Hystopathological examination revealed features consistent with the diagnosis of hemangioblastoma. Other stigmata or familiar history of VHL disease were absent.
CONCLUSIONS: Review of the literature confirms that cranial nerve hemangioblastomas are very rare lesions that occur sporadically or in association with VHL disease. Surgical management of such lesions should be directed by clinical and radiological features as well as patient expectations.