A cystic ring-enhancing cerebellar lesion

Abstract

Considering the patient's MRI appearance, astrocytoma seems the correct choice at first glance. But in fact, postoperative histopathologic examination demonstrated the diagnosis of hemangioblastoma (Fig. 2C). This is an especially rare neuroradiologic manifestation of cerebellar hemangioblastoma, with enhanced cystic wall in Gd-enhanced MRI sequences; and her CT angiographic with abnormal vessels on the surface of the cystic mass may explain this rare phenomenon (Fig. 2A).Hemangioblastomas comprise 2% of all intracranial tumors, and 7-10% of posterior fossa tumors, with a predilection of cerebellum, brainstem and the spinal cord. They preferentially occurs in middle-age people, majority in the fourth and fifth decades, with no gender predilection [1]. Approximately 75% of hemangioblastomas occur in sporadic form, but there are still a small number of patients associated with Von Hippel-Lindau (VHL) disease [2]. The symptoms or signs of sporadic hemangioblastomas includes headache, vertigo, blurred vision, nausea or vomiting, extremity paresis, decreased hearing, facial paresthesia and consciousness diaturbance [3], and it varies according to the specific tumor location and tumor size.Based on neuroimaging appearances, hemangioblastomas can be divided into three patterns: one is a large unenhanced cyst with small enhanced tumor nodules, the other two are solid enhanced