Conus Medullaris Hemangioblastoma with Arteriovenous Shunting a Diagnostic Challenge

Congress:

2023 ASM

Poster Number:

C-191

Type:

Educational Exhibit

Keywords:

Neuroradiology spine, MR, Other, Cancer

Authors:

R. Sharma, S. Bhuta

DOI:

10.26044/ranzcr2023/C-191

DOI-Link:

https://dx.doi.org/10.26044/ranzcr2023/C-191

Background

68yo female presented with symptomatic conus lesion. This was evaluated with CT/CTA/MRI/MRI+C/MRA preoperatively. Radiological findings favoured Myxopapillary Ependymoma because of its location with associated arteriovenous shunting. Final histology was consistent with Hemangioblastoma.

Fig 1: heterogeneously enhancing intramedullary conus Hemangioblastoma

Fig 2: heterogeneously enhancing intramedullary conus Hemangioblastoma with central...

Fig 3: intratumoural T2WI-hyperintense cyst

Fig 4: Lack of cord signal change, syrinx/syringomyelia or hemosiderin deposition

Fig 5: prominent draining vein caudally

Fig 6: cranially arterialised vessels on CTA

Fig 7: cranially arterialised vessels and caudal high-flow drainage indicated...

Fig 8: TWIST MRI appearance of conus Hemangioblastoma (Sagittal view)

Fig 9: TWIST MRI appearance of conus Hemangioblastoma (Coronal view)

Fig 10: prominent vein seen coursing inferiorly within the thecal sac up to the S2...