Sporadic Hemangioblastoma Arising from the infundibulum
A 38-year-old female presented with a 9-month history of headaches and amenorrhea. Laboratory workup revealed low leutenizing hormone LH and follicle stimulating hormone FSH. Her past medical history includes irregular menses, remote history of melanoma excision from her thigh, and surgical removal of an ovarian cyst as a child. MRI of the pituitary was performed. Magnetic resonance imaging (MRI) exam of the pituitary found the pituitary gland to be within normal limits in appearance but relatively small in size with a maximum height of approximately 3 mm. For a woman in the childbearing years, this pituitary size was considered small. Additionally, a 13 x 13 x 13.2 mm homogeneously enhancing spherical mass was seen in the upper half of the infundibulum, which appeared to arise from the infundibulum itself and impinge upon the undersurface of the optic chiasm and third ventricle. The mass was isointense relative to the cortex on T1- and T2-weighted images, and enhanced avidly and homogeneously after contrast administration (Figure 1). The patient underwent endoscopic transsphenoidal resection of the mass, which was a hemangioblastoma based on histopathology. TEACHING POINT We report a sporadic case of solitary, non-cystic hemangioblastoma arising from the infundibulum and appearing quite similar to a pituicytoma and chordoid glioma. This demonstrates that, while rare, hemangioblastomas must be considered on the differential diagnosis for an avidly enhancing suprasellar mass.