Cerebellar Hemangioblastoma

Abstract

Thirty-eight-year-old male presented with two months
history of progressive headache (better with standing,
worse with lying flat), nausea and vomiting, and gait
imbalance (veering to the left).
Magnetic resonance imaging (MRI) (Fig. 1) demonstrates a mostly cystic mass arising from the right cerebellar hemisphere with maximum axial and longitudinal
dimensions of 5.1 × 4.1 cm and 3.7 cm, respectively.
The mass is mostly cystic, with an enhancing nodule situated laterally. Dimensions of the enhancing nodule are
about 2.2 × 1.2 cm in axial and 2.2 cm in longitudinal
axis. The mass creates mass effect upon the fourth ventricle and cerebral aqueduct, displacing the left cerebellar hemisphere. Pilocytic astrocytoma and hemangioblastoma are considered the most likely etiologies. At
this age, hemangioblastoma is the most likely diagnosis.
Other less likely considerations are high-grade glioblasFigure 2. Antero-posterior and lateral angiographic
images
toma, ependymoma, and medulloblastoma. Pilocytic
astrocytomas have a correlation with neurofibromatosis
and hemangioblastomas have a correlation with Von
Hippel-Lindau disease.