VHL: Evaluate for hemangioblastomas and endolymphatic sac tumors. Known retinal angiomas status post laser treatment. Brain: There is an unchanged punctate enhancing lesion along the posterior aspect of the cervicomedullary junction region. There is no evidence of intracranial hemorrhage or acute infarct. There is minimal scattered cerebral white matter T2 hyperintensity. The inner ear structures are unremarkable, without evidence of endolymphatic sac mass lesions. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a left lens implant. There is slight irregularity along the left posterior globe.Spine: Aside from the lesion at the cervicomedullary junction, there is no evidence of abnormal enhancement or mass lesions elsewhere within the spinal cord or spinal canal. There is multilevel degenerative spondylosis of the cervical spine with spinal canal stenosis and mild indentation upon the spinal cord, as well as neural foraminal stenoses. There is associated mild straightening of the cervical spine in the sagittal plane. The vertebral column alignment is otherwise within normal limits. There are mild disc bulges at L4-5 and L5-S1 with mild neural foraminal stenoses, but no significant spinal canal stenosis. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable, aside from dependent subcutaneous edema in the lower back. There are left renal cysts.
1. An unchanged punctate enhancing lesion along the posterior aspect of the cervicomedullary junction region is compatible with a hemangioblastoma.2. No evidence of spinal hemangioblastomas.3. No evidence of endolymphatic sac tumors.4. Slight irregularity along the left posterior globe may correspond to the known retinal angiomas and/or laser treatment.5. Multilevel degenerative spondylosis of the cervical and lumbar spine.6. Left renal cysts. Please refer to the separate abdomen MRI report for additional details.