Monitoring of hemangioblastoma. There is redemonstration of an enhancing lesion located in the left posterior inferior aspect of the cerebellum which measures 13 x 15 mm and is unchanged compared to the prior exam. There is a smaller adjacent enhancing lesion which has increased in size, now measuring 8 mm compared to 3 mm on the 9/30/2014 exam. However, this lesion appears similar in size when compared to the 1/24/2014 exam. There is a moderate amount of associated vasogenic edema which is increased compared to the 9/30/2014 exam. However, the amount of vasogenic edema, like the size of the enhancing lesion, also appears similar when compared to the 1/24/2014 exam. There are overlying skull changes compatible with post craniotomy status.A mild degree of periventricular and subcortical punctate hyperintense white matter lesions are again seen on the FLAIR and T2 images, unchanged.There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. No abnormal extra-axial fluid collection is identified. There is no midline shift or mass effect. There is an empty sella. The midline structures and craniocervical junction are otherwise within normal limits. Normal flow-voids are demonstrated in the major intracranial vascular structures.The paranasal sinuses are clear. There is partial opacification of the right mastoid air cells which is unchanged compared to prior. The left mastoid air cells are within normal limits. The orbits are unremarkable.The imaged portions of the cervical spine reveal disc bulge at C3-4 with mild central spinal canal stenosis, unchanged.
Two nodules of enhancement in the left inferior cerebellum are compatible with residual hemangioblastoma. The larger of these lesions appears stable. However the smaller lesion appears to fluctuate in size. Although this lesion has increased when compared to the past two exams, it is similar in size compared to the January 2014 exam. Similarly, the amount of associated vasogenic edema appears increased when compared to the past two exams but is similar in extent compared to the January 2014 exam. 