Intramedullary cervical spinal cord and cerebellar hemangioblastoma: A case report

Abstract

Background: Hemangioblastomas are benign tumors that develop in the central nervous system. They represent 1.5-2.5% of all intracranial tumors, and about 2-15% of all spinal cord tumors. They are highly associated with von Hippel-Lindau disease.

Case description: A 36-year-old female presented with a 4-year history of progressive right upper extremity distal weakness and cervical pain. The magnetic resonance imaging demonstrated a homogeneously, contrast enhancing intradural/intramedullary tumor at C6-C7 with perilesional edema and a syrinx accompanied by a cerebellar cyst with a mural nodule. Surgery included excision of the spinal lesion and decompression and excision of the cerebellar cyst and mural nodule (i.e., median suboccipital craniectomy and cervical C5-C7 laminectomy).

Conclusion: Surgery is the gold standard treatment for symptomatic hemangioblastomas, and surgical approaches should minimize risk.

Keywords: Hemangioblastoma; Neurosurgery; Spine; Spine surgery; von Hippel-Lindau.

Figure 1:

MRI of the cerebellum. (a) T2-weighted MR images revealed a cyst lesion with edema. (b) T1-weighted Gd-enhanced axial image revealing an hypointense mass at the cerebellar left hemisphere.

Figure 2:

MRI of the cervical spine. (a) T2-weighted MR images revealed a syrinx with edema. (b) T1-weighted Gd-enhanced sagittal image revealing an intramedullary intradural isointense mass (arrow) at the C6-C7 level.

Figure 3:

Median suboccipital craniectomy, transcortical approach showing mural nodule (yellow arrow).

Figure 4:

Posterolateral sulcus approach for the cervical spinal cord intramedullary tumor. Tumor (yellow arrow).

Figure 5:

Macroscopic complete resection of the spinal cord lesion.

Figure 6:

Postoperative MRI.