Fig. 18. Axial T1W post gadolinium images of posterior fossa (A) and orbits (B) from brain and orbital MRI on patient who presented with headaches.

Enhancing lesion is observed in region of fourth ventricle complicated by hydrocephalus (not shown). Additional avidly enhancing lesion is seen arising from lateral choroid of left globe without associated chorioretinal detachment. These findings are suggestive of cerebellar and retinal/choroidal hemangioblastomas, although associated cystic component for cerebellar lesion is more typical. Underlying Von Hippel-Lindau disease was key consideration. Metastases are less likely given patient's young age (< 40 years old) and no known history of primary malignancy. Histology following resection of cerebellar lesion confirmed diagnosis of hemangioblastoma. T1W = T1-weighted