Von Hippel Lindau Syndrome

Findings:

Axial T1 post contrast images demonstrate multiple small solid enhancing nodules in both cerebellar hemispheres with no significant mass effect. Postoperative changes of suboccipital craniotomy are incompletely included with a surgical defect in the right cerebellar vermis. Sphenoid sinus inflammatory disease is also incompletely included.

Discussion:

The presence of multiple solid nodular enhancing lesions should raise the possibility of metastases first. The presence of a surgical defect indicates that this is likely a recurrent process. With absence of significant atrophy, this patient is relatively young and therefore typical metastatic disease is less likely, and underlying inherited multiple tumor syndromes should be considered such as vHL.

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