Craniocervical junction hemangioblastoma
Familial history of von Hippel Lindau syndrome.
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18*24*36 mm cystic mass located posteriorly at the craniocervical junction. The larger non-enhancing cystic component which is present anterosuperiorly with a small and intensely enhancing nodule located posteroinferiorly abutting the pia mater.
The cystic component appears intra-axial and separate from the fourth ventricle.
The medulla is compressed anteriorly with effacement of the premedullary cistern.
A few abnormal foci of enhancement also is seen at the right and left cerebellar hemispheres.
Although the location is unusual (and probably arises from the medulla), the imaging features are fairly typical for hemangioblastoma.