PMC9092942_01
Changes of hemangioblastoma of the magnetic resonance imaging (MRI). (A) A space-occupying lesion at L1-L2 was detected (red arrow) in May 2016; (B) A recurrent site at S1 was observed (red arrow) after the first surgery in July 2019; (C) Two recurrent sites at L2 and S1-S2 were discovered (red arrow) after the second surgery in June 2020.
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The magnetic resonance imaging (MRI) showed a space-occupying lesion at L1-L2 ( Figure 1A ). She underwent a MRI of the lumbar spine which showed a space-occupying lesion at S1 ( Figure 1B ), thus the tumor resection was performed again. In June 2020, MRI indicated tumor recurrence at L2 and S1-S2 ( Figure 1C ).
Anlotinib resulted in tumor regression of multiple recurrent lumbar and sacral cord hemangioblastoma. This is a sagittal magnetic resonance imaging (MRI) view of lumbar and sacral spine; (A) The two lesions at L2 and S1-S2 were observed to have increased in size (red arrow) in June 2021; (B) The MRI demonstrated tumor regression (red arrow) following one month of anlotinib in July 2021; (C) The MRI showed further regression in the enhancing tumor (red arrow) following three months of anlotinib in Sep 2021.
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In June 2021, tumor progression was observed. the MRI showed that the diameter of two lesions at L2 and S1-S2 increased to 1.8cm and 2.3cm respectively ( Figure 2A ). T2 signal change around the enhancing component, as well as a decrease in the size on the MRI from 1.8cm to 1.0cm at L2 and from 2.3cm to 2.0cm at S1-S2 after use of one month ( Figure 2B ). To date of Sep 22, 2021, the MRI demonstrated further decrease in the dimensions of residual lesions ( Figure 2C ). The patient was in good condition, evaluated as having partial response in accordance with the RECIST 1.1 system.
The treatment timeline of the patient with multiple recurrent hemangioblastoma.
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The treatment timeline of the patient is depicted in  Figure 3 . The patient has given her consent for the case report to be published.