Female, 62 years old, with bone Hippel-Lindau disease and history of cerebellar hemangioblastomas. Assess for growth of existing lesions and for any new lesions. Attention to the inner ears/petrous temporal bone to assess for endolymphatic sac tumor. A 6 mm enhancing nodule is evident within the left cerebellar hemisphere adjacent to the foramen of Luschka. A 3 mm focus of enhancement is evident within the inferior medial right cerebellar hemisphere. These lesions are associated with mild surrounding T2 hyperintensity but no significant mass effect is observed.No evidence of any supratentorial enhancing lesion is seen. Multiple scattered foci of white matter T2 hyperintensity are identified in the cerebral hemispheres, a nonspecific finding which most likely represents chronic microvascular ischemic disease. No evidence of restricted diffusion is seen. No abnormal extra-axial fluid collection or acute intracranial hemorrhage is observed. The ventricles and sulci are mildly prominent compatible with underlying parenchymal volume loss.Dedicated imaging of the internal auditory canals shows normal morphology of the fluid filled compartments of the inner ears. No evidence of any destructive or enhancing inner ear lesion is seen to suggest the presence of an endolymphatic sac tumor. The cranial nerve VII and VIII complexes are within normal limits. No masslike lesions are seen in the CP angle cisterns.
1.Two enhancing nodules are evident within the cerebellum compatible with hemangioblastomas. These are associated with mild signal abnormality in the surrounding parenchyma, but no significant mass effect. A complete outside MRI for comparison was not available at the time of this interpretation. If such an exam can be made available, we will be happy to make a comparison and addend this report.2.No evidence of any supratentorial enhancing lesion is seen. Scattered foci of white matter signal abnormality likely reflect chronic microvascular ischemic disease.3.Evaluation of the internal auditory canals is within normal limits. Specifically, no evidence of an endolymphatic sac tumor is seen.