Spinal hemangioblastoma

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Paraplagia and neck pain.

Patient Data

Age: 30 years
Gender: Male

Cervical spine

mri
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Sagittal
T1
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Sagittal
T2
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Sagittal
T1 fat sat
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Sagittal T1
C+ fat sat
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Sagittal
DWI
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Sagittal
ADC
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Axial T1
fat sat
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Axial T2
fat sat
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Axial
T2
This study is a stack
Axial
T2
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Sagittal
T2
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Info

An eccentric dorsal cord-based mass lesion is noted with intramedullary and extramedullar components is seen opposite to C7/D1 level averaging roughly 19 x 9.5 mm, seen indenting cord from its posterior aspect. It is exerting T1 mild hypo and T2 iso intense signals. It indents manifestly the related cord with anterior displacement. The tumor nidus enhances avidly.

Cord syrinx is noted extending from C5 to D5 vertebral levels.

Left vertebral artery

dsa
Frontal Lt
vertebral
Frontal Lt
vertebral
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Info

Digital subtraction angiography of the left vertebral artery shows a feeding vessel supplying the spinal mass originating from its proximal segment.

Intraoperative

pathology
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Info

Operative photos showing a vascular spinal mass lesion at the cervical spinal cord.

Case Discussion

The imaging features shows a vascular spinal tumor with multiple tortious vascular channels within its substance and associated syrinx. The case was pathologically proved spinal hemangioblastoma - pathology report unavailable. The patient improved dramatically after the operation.

 

Case courtesy Dr. Mohamed Kaed, consultant radiologist, Dar Al-Ashaa, Alexandria, Egypt.

Case courtesy Dr. Mostafa Al-Askary, lecturer of neurosurgery, Alexandria university, Egypt.

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