Hemangioblastoma (multiple)

Case contributed by Dr Nikola Todorovic
Diagnosis almost certain

Presentation

Vertigo and vomiting. Previous surgeries and gamma knife treatment for posterior cranial fossa tumors.

Patient Data

Age: 50 years
Gender: Male
mri

Multiple tumors in cerebellar hemispheres, vermis, 4th ventricle, cerebellomedullary cisterns, and intramedullary spinal cord. Lesions are hyperintense on T2W/FLAIR, hypointense on T1W, with strong postcontrast signal intensity enhancement. Some of the lesions are cystic with a solid tumor nidus, showing no enhancement of the cystic component.

Signs of myelopathy in the cervical part of the spinal cord.

Case Discussion

The patient was operated on twice for posterior cranial fossa tumors, histologically proven to be hemangioblastomas and also underwent gamma knife treatment for three similar lesions.

Now presents with similar symptoms as before the previous treatments, with MRI brain showing multiple tumors that most probably represent hemangioblastomas.

No family history or abdominal lesions suggest von Hippel-Lindau syndrome.

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