Presentation
Giddiness
Patient Data
MRI demonstrates a space occupying lesion involving the left cerebellar hemisphere. The lesion has a solid cystic appearance with the solid component demonstrating intense enhancement on post contrast images while there is no enhancement of the cystic component wall. There is mass effect in the form of compression of left middle and inferior cerebellar peduncles and fourth ventricle causing proximal dilatation of third and lateral ventricles. On post contrast images, a feeding vessel is seen to supply the solid component of the lesion.
Case Discussion
Features suggest possibility of hemangioblastoma most likely .
Differential diagnosis:
Pilocytic astrocytoma - more common in children; demonstrates enhancement of the cyst wall.
Metastases - demonstrates significant perilesional edema with history of known primary.
Unfortunately, the patient couldn't be followed up and histopathological confirmation has not been done.