PMC6293603_01
T1-weighted images (T1WI) with contrast of magnetic resonance imaging (MRI) show a uniformly enhanced intramedullary tumor with contrast at C2 level (a). In T2-weighted images (T2WI), significant edema was noted down to T1 level (b)
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F1
T2* was identified within and extending from the anterior limit of the tumor, suggestive of acute hemorrhage into an intramedullary hemangioblastoma [Figures 1a, b and 2a, b]. The contrast-enhanced computed tomography identified a well-circumscribed hypervascular mass measuring 13 mm x 9 mm x 11 mm, with a prominent, tortuous vessel emerging from the posterior aspect of the tumor [Figure 3a and b].
In T2* sequence of MRI, low intensity area was noted within (a) and anterior to the tumor (b), which suggested intratumoral/intramedullary hemorrhages from the tumor
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F2
T2* was identified within and extending from the anterior limit of the tumor, suggestive of acute hemorrhage into an intramedullary hemangioblastoma [Figures 1a, b and 2a, b]. The contrast-enhanced computed tomography identified a well-circumscribed hypervascular mass measuring 13 mm x 9 mm x 11 mm, with a prominent, tortuous vessel emerging from the posterior aspect of the tumor [Figure 3a and b].
Computed tomography (CT) images of sagittal (a) and coronal (b) section demonstrate a clearly circumscribed hypervascular tumor sized in 13 x 9 x 11 mm with a tortuous vessel posteriorly to the tumor
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F3
T2* was identified within and extending from the anterior limit of the tumor, suggestive of acute hemorrhage into an intramedullary hemangioblastoma [Figures 1a, b and 2a, b]. The contrast-enhanced computed tomography identified a well-circumscribed hypervascular mass measuring 13 mm x 9 mm x 11 mm, with a prominent, tortuous vessel emerging from the posterior aspect of the tumor [Figure 3a and b].
T1WI with contrast in MRI demonstrated complete resection of the tumor (a). In T2WI, high-intensity area significantly improved over time [(b) postoperative day (POD) 6; (c) POD 11; (d) POD 18)
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F4
T2 cord hyperintensity [Figure 4b-d]. Two months postoperatively, the patient had no residual motor deficit, but a residual severe upper and lower sensory deficit bilaterally below T5.
Pathology specimen pictures of the tumor. In high power view of hematoxylin and eosin (HE) staining, tumor cells had an abundant clear vacuolated cytoplasm and small uniform nuclei, which is characteristic to hemangioblastoma (a). Intratumor hemorrhage was identified (b)
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F5