Hemangioblastoma - Von Hippel–Lindau syndrome
Hypertension, palpitation, weight loss and vertigo.
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Abnormal signal intra axial enhancing masses associated with vasogenic edema are seen at the posterior fossa causing to expansion of cerebellar hemispheres, impinging forth ventricle and encroaching to posterior aspect of brain stem.
Right sided ventricular shunt is present.
high signal intensity white matter lesions are seen at periventricular, centrum semiovale and juxta cortical regions due to small vessels ischemic changes in the background of chemotherapy and radiotherapy effects.
Prior to this presentation, the patient had a pathologically proved of the malignant pheochromocytoma and bilateral renal enhancing masses likely to renal cell carcinoma (see case rID:62415)
Two month ago and after completion of treatment, patient was symptomatic and referred with a history of hypertension, headache, vertigo and weight loss and brain MRI was done and regarding to imaging findings highly suggestive of multiple hemangioblastomas. A metastasis is the main differential diagnosis.