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Case No. 137
0000-00-00~0000-00-00
출제자 : 관리자
Hit : 290
| Period | 0000-00-00~0000-00-00 |
|---|---|
| Diagnosis | |
| Clinical information | 39세 여자. 5개월간의 posterior neck pain으로 내원 |
| Discussion | 정답: Hemangioblastoma Hemangioblastoma Review - 7% of posterior fossa tumors in adults - the most common intraaxial neoplasm of the adult posterior fossa after metastasis. - between 4% and 40% meet criteria for von Hippel-Lindau syndrome - peak in incidence during the fifth and sixth decades Imaging Findings - cerebellum is their most frequent site, also in the medulla or the spinal cord - usually solitary lesions; multiplicity is said to occur in 20% of patients with von Hippel-Lindau syndrome - 대부분 cyst with mural nodule, cyst wall is not involved with tumor nodule abut pial surface, with vascular signal void and marked enhancement - Entirely solid hemangioblastomas occur in 30% to 40% of cases - 때로 cyst wall enhance: not typical 본 증례의 경우 solid portion 외에 cyst rim-enhance되는 부분이 있고 severe edema가 있어 high grade glioma로 오인 할 수 있으나 pial surface에 연하여 있고 T2WI상 vascular signal void가 있어 hemangioblastoma를 진단할 수 있는 case임. CBV는 10배 이상 매우 증가되어 있으며 이는 hemangioblastoma와 맞는 소견이며 GM이나 metastasis보다 높으나 specific하지는 않음. MRS상 Cho/Cr ratio가 3.35로 증가되어 있어 GM과 혼동되는 소견임. |
| Correct answer |
Correct AnswerSemi-Correct Answer |