Large cystic cavernous angioma of the cerebellum mimicking pilocytic astrocytoma.

Objective And Importance: Cavernous angiomas are relatively rare vascular malformations. They are generally located supratentorially with a rare incidence in the cerebellum. Cavernous angiomas, accompanied by a large cyst, are very rare. We present a case of a cavernous angioma with the unusual MRI findings of a large cyst and a small mural nodule.

Clinical Presentation: The patient was a 48-year-old man who complained of a history of dizziness for several weeks. The neurologic examination in the neurosurgery clinic was without deficit.

Intervention: The cyst measured 4.7x4.0 cm and contained serous fluid with a nodular mass in the lower part of the cyst. The cystic wall and the solid mural nodule were completely removed through a midline suboccipital approach. Postoperatively, the patient remained neurologically intact.

Conclusion: When a large cystic lesion is present in the cerebellum, preoperative radiological and intraoperative findings led to misdiagnosis. Therefore, a rare cystic angioma must be considered in the differential diagnosis of infratentorial cystic masses.