Case 038

History/Physical

History/physical:

55-year-old right-handed male.

Progressive gait ataxia over one year.

Dysmetria on right finger-nose testing.

There is a large cystic mass in the right cerebellum. There is a small solid nodule posteriorly (*). There is surrounding edema (arrows). Mass effect distorts the 4th ventricle (arrowhead).

The lateral ventricles are enlarged (*) and there is transependymal CSF flow (arrows). This is compatible with obstructive hydrocephalus.

The nodule enhances (arrow).

The cyst has intermediate signal (*), which indicates the fluid is not simple.

Diagnosis: Hemangioblastoma

Highly vascular lesion with large and small vascular channels.

Stromal cells (*) with clear to bubbly cytoplasm are found between small vascular channels.