PMC7484534_01
Brain MRI showing a lesion located in the left CPA. The first image is an axial Flair image that shows a lesion with a hypointense signal in relation to brain tissue and an edema signal in the cerebellar parenchyma. The second and third images, axial and coronal T2-weighted images, show heterogeneous signal intensity.
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T1-weighted sequences; hypointensity and heterogeneity on T2-weighted sequences; and intense homogeneous contrast enhancement located in the left CPA region and extending superiorly to the tentorial notch as well as medially displacing the superior cerebellar peduncle and dorsal portion of the midbrain. The larger dimensions were 2.6 x 2.7 x 2.4 cm (anterior x lateral x superior) (Fig. 1, Fig. 2).
A morphological finding of proliferation of variable sized, closely packed, thin walled vessels and large neoplastic stromal cells with pink to clear foamy cytoplasm with fine vacuoles and strong inhibin expression, indicates the diagnosis of hemangioblastoma. In addition, the negativity to anti epithelial membrane antigen (EMA) and progesterone receptors excluded the possibility of meningioma.
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The pathology report revealed a hemangioblastoma (Fig. 3).
Axial, sagittal and coronal gadolinium-enhanced T1-weighted MRI 18 months after surgical treatment that do not show evidence of residual lesion or recurrence.
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In the long-term follow-up, MRI examinations 6 months and 18 months after surgery (Fig. 4) showed gross total resection and no signs of recurrence.