Cerebellar Hemangioblastoma in a Patient with a History of Breast Carcinoma: A Case Report and a Brief Review of the Literature

Abstract

Cerebellar hemangioblastomas (CHs) are rare benign vascular tumors that can pose a diagnostic challenge, especially in patients with a prior history of malignancy. CHs have a radiologic appearance analogous to metastatic lesions, which can lead to potential misdiagnoses and thus require a multimodal approach for the right diagnosis. We present a case of a 51-year-old woman with a past medical history of breast carcinoma (BC), who gradually developed progressive cerebellar symptoms. Imaging of the brain showed a mass in the cerebellum with marked edema, which was thought to be metastatic breast carcinoma (MBC). However, histopathological examination and immunohistochemical (IHC) studies helped establish the diagnosis of CH. The surgery was performed, but two years later, the tumor grew back. The patient then underwent radiotherapy with no evidence of tumor recurrence in the following 26 months. This case shows that CHs can be difficult to diagnose, especially in patients with a history of cancer. Histopathology and IHC studies are essential for diagnostic accuracy. Prompt recognition and management, which may include surgery and adjuvant radiotherapy in case of recurrence, can result in good long-term outcomes. In addition to metastatic disease, progressive cerebellar symptoms should raise the possibility of CHs in the posterior fossa in patients with a history of cancer. This report emphasizes the importance of a multidisciplinary approach to diagnosing and managing these tumors, including imaging, histopathology and IHC studies.