A case report of cerebellar hemangioblastoma simulated brain metastasis shown by magnetic resonance imaging

Abstract

Rationale: Hemangioblastomas occur both sporadically and as an important component of von Hippel-Lindau (VHL) disease. The typical MRI features of hemangioblastoma are cysts with enhanced cystic wall nodules in the cerebellum or lesions with uniform enhancement on the surface or inside the spinal cord. If there is edema around hemangioblastoma, it is easy to be misdiagnosed as brain metastasis on MRI. Patient concerns: A 41-year-old male patient was found to have a lump in the pancreas during a health examination 3 months ago. Subsequently, the patient underwent surgical treatment. The postoperative pathology suggests that the pancreatic lesion is a neuroendocrine tumor. The patient subsequently came to our hospital for consultation on further treatment plans. Abnormal signals were found in the right cerebellum during pituitary magnetic resonance imaging (MRI) before the development of a treatment plan for neuroendocrine tumors. Subsequently, the patient underwent cerebellar mass resection surgery. The pathological result after the surgery was hemangioblastoma. Diagnosis: The patient underwent surgery to remove the tumor and was diagnosed with hemangioblastoma by pathological examination. Subsequently, the patient’s genetic testing results confirmed the diagnosis of VHL syndrome. Interventions: The patient underwent cerebellar mass resection surgery. Outcomes: The patient recovered after surgical resection. Lessons: In this report, we emphasize the atypical MRI manifestations of hemangioblastoma. For patients with VHL syndrome-related hemangioblastoma, genetic testing is necessary for the patient and their family members.

Cerebellar Hemangioblastoma Mimicking Arteriovenous Malformation: A Case Report

“…Magnetic resonance imaging (MRI) is most commonly used to diagnose HBM. The solid part of HBM manifests as iso-or hypointense on T1-weighted images, hyperintense on T2-weighted images, and a significant contrast enhancement on T1 post-contrast [4]. Cystic hemangioblastoma resembles arteriovenous malformation (AVM) in imaging features, characterized by an apparent vascular blush, the presence of multiple feeding vessels, and evident draining veins observed on digital subtraction angiography (DSA) [4].…”