Hemangioblastoma, case 3

Clinical history
This 22-year-old woman presented with a six year history of nocturnal low back pain. Recently she developed a right S1 radiculopathy. An initial MRI, performed at another institution, was reported to show a lower thoracic and conus syringomyelia, considered to be of congenital origin, although no Chiari malformation was found at the cranio-cervical junction.

On clinical examination the sole abnormality was loss of the ankle jerk on the right side. Degree of disability: McCormick I. As the clinical symptomatology slowly progressed, a follow-up MRI was performed at our institution.

Pre-operative MRI
Images 1 - 4: Sagittal T1WI. Syringomyelia of the conus is clearly seen.
Image 5: Sagittal Gd T1WI and image 6 with Gd (right) and without Gd T1WI. A cystic lesion of the conus expands the spinal cord. After contrast injection, a small nodular tumor becomes obvious as it enhances homogeneously and markedly.
Images 7 - 8: Axial T1WI. The axial view shows the central cystic lesion clearly. The solid nodule is barely visible.
Images 9 - 10: Axial Gd T1WI. The enhancing nodule is posteriorly located and is very well seen in this axial view.

Surgery
Surgery was performed and the nodule was totally removed.

Histology
Hemangioblastoma.

Post-operative clinical course
After surgery the patient's clinical condition was unchanged and remained stable after three years of follow-up (McCormick I).

Search also:
- Hemangioblastoma

The ESNR CD-Rom Series