Hemangioblastoma, intraventricular

NEUROLOGICAL EXAMINATION is normal.

CT:
a) NON-CONTRAST SCAN (IMAGE 1): A small mass is seen (arrow) in the atrium of the right lateral ventricle with surrounding edema.

b) CONTRAST-ENHANCED SCAN (IMAGE 2): Intense enhancement of the tumor is noted (arrow).

MRI:
a) TRANSAXIAL T2-WEIGHTED (2500/90/1) SPIN-ECHO SEQUENCE (IMAGE 3): Widening of the atrium of the right lateral ventricle is identified. A rounded mass lesion is seen within the lateral ventricle. Signal voids (arrowhead) point to hypervascularity. Surrounding edema is noted.

b) CORONAL T1-WEIGHTED (520/15/1) SPIN-ECHO SEQUENCE (IMAGES 4 AND 5): The mass is hypointense, with intratumoral signal voids (arrowheads). Entrapment of temporal horn of right lateral ventricle is appreciated.

c) CORONAL (IMAGES 6 AND 7) AND SAGITTAL (IMAGE 8) GADOLINIUM-ENHANCED SPIN-ECHO SEQUENCES: Intense enhancement of the lesion is appreciated. Again note the intraventricular location and the enlarged and entrapped temporal horn.

ANGIOGRAPHY: Lateral projection of selective right internal carotid artery (IMAGE 9) and right vertebral artery injection (IMAGE 10). The tumor is hypervascular and supplied by choroidal branches.

RADIOLOGICAL DIFFERENTIAL DIAGNOSIS mainly includes meningioma, choroid plexus papilloma, ependymoma and hemangioblastoma.

SURGICAL FINDINGS: At surgery, a red-purple well defined, highly vascular tumor was found in the atrium of the right lateral ventricle. The mass adhered to the posterior wall of the thalamus and was inserted on the choroid plexus. Resection was total.

ANATOMOPATHOLOGY was consistent with hemangioblastoma, associated with Von Hippel-Lindau disease.

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Hemangioblastoma

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