A case of haemangioblastoma of the fourth ventricle presenting with depression

Haemangioblastoma (Hab) is a rare, benign and slow-growing tumour of uncertain histiogenesis. It constitutes roughly 1% to 2% of all intracranial tumours and most commonly arises in the posterior cranial fossa: more than 80% of Habs are located in the cerebellar hemispheres, the remaining cases lie in the vermis, brainstem and spinal cord. In about 20% of the cases Habs are associated with the hereditary disorder known as von Hippel-Lindau disease (VHL). Usually, Hab presents with symptoms of increased intracranial pressure and focal neurological symptoms, which depend on the tumour location. Here, a case of Hab localised in the fourth ventricle that manifested with an unusual clinical picture featuring predominant psychiatric symptoms is described; the condition went unrecognised until the patient's death.