Ital. J. Neurol. Sci. 1." 99-102, 1983 Cerebral and cerebellar haemangioblastoma occurring in the same patient Di Lorenzo N., Spallone A., Morselli E. lstituto di Neurochirurgia Universitgt di Roma A middle-aged man who had undergone two previous operations on a cere- bellar haemangioblastoma was found at CT follow-up thirteen years later to have a double supra-and infra-tentorial haemangioblastoma. The tumors were confirmed by vertebral angiography and removed by two-stage surgery. The importance of careful CT follow-up to detect the recurrence of multifocal haemangioblastoma is clear. Key-Words: haemangioblastoma -- supratentorial tumor -- infratentorial tumor -- computed tomography Introduction Supratentorial haemangioblastoma is rare. About forty cases have been reported by Toma- sello et al [12] in a recent review paper and other cases have been reported by Modkar et al [7], McDonnel and Pollock [6], Tomaccini et al [11] and Ferrante et al [2]. The occurrence of supratentorial and cerebellar haemangioblastoma in the same patient is ex- ceptional. In fact, only seven cases have been reported in the literature [12], including the one described here. Case report A 51-year-old man, with no family history of von Hippel-Lindau disease, underwent two op- erations elsewhere in 1961 and 1968 because of a right cerebellar haemangioblastoma diagnosed by pneumoencephalography and angiography. He was admitted to our Institute in March 1981 because of increasing vestibulo-cerebellar dys- function and bilateral papilloedema; routine blood analysis was normal except for haemato- crit 50%, haemoglobins 19.2% and red cell count 6.1 million per cubic centimetre. A CT scan showed a large lesion of slight hyper- density in the right posterior fossa and another in the left temporo-occipital region. Subsequent infusion of contrast medium showed significant enhancement of both these lesions with the clear appearance of a cystic component and a mural nodule (Fig. 1 a and b). Transfemoral vertebral angiography confirmed the two lesions, both of which showed early arterial filling and pro- longed venous blush, and a definite cystic com- ponent (Fig. 2, a and b). Both tumors were removed over a three-month interval, first the right cerebellar, then the left temporo-occipital. The lesions were histologi- cally similar, having the characteris of haeman- gioblastoma. No residual tumors were seen upon post-opera- tive CT scan, nor were lesions found at other sites. At six-month follow-up, mild vestibulo- cerebellar impairment and expressive dysphasia were present. Discussion The occurrence of anatomically distinct tumors, supra-and infra-tentorial, with the morphology 99