VHL with pre-existing brain and spine hemangioblastomas. Brain: There are multiple subcentimeter enhancing lesions in the posterior fossa, including the medulla and cerebellum, some of which display associated edema. There is no evidence of intracranial hemorrhage or acute infarct. There is unchanged mildly prominent sulcus in the superior let parietal lobe. The supratentorial brain parenchyma otherwise appears unremarkable. 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 orbits, skull, and scalp soft tissues are grossly unremarkable. There is diffuse paranasal sinus mucosal thickening. The retropharyngeal lymph nodes appear unchanged.Thoracic Spine: There is an unchanged enhancing lesion in the posterior spinal cord at the T10-11 level that measures up to 5 mm, with extensive surrounding edema. There are punctate enhancing lesions at the T2 and T6 levels. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. There are multiple bilateral complex renal cystic lesions. There are also multiple pancreatic cystic lesions.
1. No significant interval change in the posterior fossa hemangioblastomas.2. No significant interval change in the spinal cord hemangioblastomas.3. Multiple bilateral renal cyst lesions, some of which may represent renal cell carcinoma. Please refer to the prior body MRI for additional details.4. Multiple pancreatic cystic lesions. Please refer to the prior body MRI for additional details.