Learning Radiology xray montage
 
 
 
 
 

Cerebellar Hemangioblastoma



 

  • Benign neoplasm
  • 80% found in cerebellum
    • Remainder in spinal cord > medulla > cerebrum
  • Account for 10% of posterior fossa masses (vestibular schwannomas and metastases rule here.)
  • Occur in ages 30 to 40
    • M > F
  • Relationship to von Hippel-Lindau disease
    • 20% occur in patients with von Hippel-Lindau disease (multiple lesions).
    • 35-60% of von Hippel-Lindau disease patients have hemangioblastomas
    • von Hippel-Lindau disease
      • Hemangioblastomas
  • Clinical findings
    • Headache
    • Ataxia
    • Nausea
    • Vomiting
    • Vertigo
    • Polycythemia caused by increased erythropoietin found in 40%.
    • Spinal lesions may present with subarachnoid hemorrhage
  • Findings on CT and MRI:
    • Cystic lesion in the cerebellum with an avidly enhancing mural nodule (75%)
    • Purely solid enhancing lesion (10%)
    • Enhancing lesion with multiple cystic areas (15%)
  • Findings on angiography:
    • Vascular nodule within an avascular mass
    • Serpentine vessels
  • Treated with surgical removal of solid nodule
    • Cystic component is not neoplastic
  • DDx:
    • Similar appearance to Juvenile pilocytic astrocytoma
      • But that is typically found in patients 5 to 15 years of age   

 cerebellar hemangioblastoma

 
Cerebellar Hemangioblastoma. MRI of brain shows a cystic lesion in the cerebellum with an enhancing nodule (post-Gadolinium)