What question did this study set out to answer?

To detail a rare case of primary cerebellar angiosarcoma and its surgical outcome.

January 10, 2026Journal of Clinical Imaging Science0 citationsOpen Access

Primary cerebellar angiosarcoma: A rare case of posterior fossa vascular tumor with hemorrhagic presentation and favorable surgical outcome

YCYi Cong ChewSengkang General Hospital PTPo Yin TangSingapore General Hospital SLSiang Hui LaiSingapore General Hospital

Key Result

Gross total resection of a low-grade cerebellar angiosarcoma resulted in no recurrence for 16 months in a 67-year-old male patient post-surgery.

Key Points

To detail a rare case of primary cerebellar angiosarcoma and its surgical outcome.
Case report of a 67-year-old male with severe symptoms.
Computed tomography and magnetic resonance imaging for diagnosis.
Histopathological evaluation confirmed diagnosis.
Patient underwent gross total resection.
Histopathology indicated low-grade angiosarcoma with high mitotic activity.
Patient remained recurrence-free 16 months post-surgery.
Imaging techniques played a crucial role in diagnosis.

Structured PICO

Population

1 67-year-old Chinese male with a history of hypertension and hyperlipidemia presenting with severe headache, unsteady gait, and giddiness due to a primary cerebellar angiosarcoma (right cerebellar intra-axial hemorrhagic lesion).

Intervention

Suboccipital craniotomy and gross total tumor resection without adjuvant therapy.

Outcome

Tumor recurrence and clinical symptoms at follow-up.

Primary cerebellar angiosarcoma is an exceptionally rare intracranial malignancy that can be successfully managed with gross total resection, emphasizing the need for multi-modality imaging and histopathological confirmation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Primary cerebellar angiosarcoma is an exceptionally rare intracranial malignancy, with only 22 cases reported in the literature. We report the case of a 67-year-old male who presented with a severe headache, unsteady gait, and giddiness. Computed tomography of the brain demonstrated a hemorrhagic lesion in the right cerebellar hemisphere with associated vasogenic edema and early hydrocephalus. Magnetic resonance imaging revealed a right cerebellar intra-axial lesion with mixed signal intensities and a characteristic peripheral “bull’s eye” enhancement pattern. Histopathological evaluation showed a vasoformative neoplasm with atypical endothelial cells, high mitotic activity, and immunopositivity for CD31 and erythroblast transformation specific (ETS)-related gene (ERG), consistent with low-grade angiosarcoma. The patient underwent gross total resection and remained recurrence-free 16 months postoperatively. This case underscores the importance of multi-modality imaging in the early recognition of hemorrhagic cerebellar tumors and reinforces the role of radiological-pathological correlation in diagnosis and treatment planning. Given its rarity, diagnosis of cerebellar angiosarcoma requires a high index of suspicion, supported by advanced imaging and immunohistochemical profiling. Multidisciplinary management is essential, and further case documentation is necessary to guide therapeutic strategies and prognostication.

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