case_images: PMC10894456_01
case_images: Initial magnetic resonance imaging (MRI) of the cervical spine (T1 post-contrast). (A) Surveillance MRI showing multiple enhancing lesions throughout the neuraxis with the largest lesion at the cervicomedullary junction measuring 9 x 9 x 12 mm (yellow arrow). (B) Three-month follow-up MRI post the belzutifan treatment showing an interval decrease in size to 5 x 7 x 9 mm (yellow arrow).
case_images: cureus-0016-00000052979-i01.jpg
case_images: PMC10894456_01_cureus-0016-00000052979-i01.jpg
case_images: FIG1
case_images: Despite clinical stability, her surveillance MRIs conducted three years post surgery revealed progression in multiple enhancing lesions throughout the neuraxis, with critical enlargement of the lesion, at least four-fold in volume, at the cervicomedullary junction (9 x 9 x 12 mm) along with extensive peritumoral edema (Figure 1, Panel A). The cervicomedullary junction mass decreased from 9 x 9 x 12 mm to 5 x 7 x 9 mm in three months with an associated decrease in the peritumoral edema (Figure 1, Panel B).
case_images: Follow-up magnetic resonance imaging (MRI) of the cervical spine at 6, 9, and 12 months, demonstrating a sustained radiologic response (T1 post-contrast). (A) Six-month cervical MRI. (B) Nine-month cervical MRI. (C) 12-month cervical MRI.
case_images: cureus-0016-00000052979-i02.jpg
case_images: PMC10894456_01_cureus-0016-00000052979-i02.jpg
case_images: FIG2
case_images: The cervicomedullary lesion measured 2 x 4 x 8 mm on 15-month surveillance imaging and 2 x 5 x 8 mm on 18-month imaging indicating a durable radiological response (Figures 2, 3, 4).
case_images: The 15- and 18-month follow-up magnetic resonance imaging (MRI) of the cervical spine (T1 post-contrast). (A) The 15-month follow-up MRI of the cervical spine. (B) An 18-month follow-up MRI of the cervical spine evidenced a sustained radiologic response.
case_images: cureus-0016-00000052979-i03.jpg
case_images: PMC10894456_01_cureus-0016-00000052979-i03.jpg
case_images: FIG3
case_images: The cervicomedullary lesion measured 2 x 4 x 8 mm on 15-month surveillance imaging and 2 x 5 x 8 mm on 18-month imaging indicating a durable radiological response (Figures 2, 3, 4).
case_images: Comparison of patient's initial magnetic resonance imaging (MRI) of the cervical spine versus at 18-month follow-up (T1 post-contrast). (A) Surveillance MRI showing multiple enhancing lesions throughout the neuraxis with the largest lesion at the cervicomedullary junction measuring 9 x 9 x 12 mm (yellow arrow). (B) An 18-month follow-up MRI post the belzutifan treatment showing a durable clinical response (yellow arrow).
case_images: cureus-0016-00000052979-i04.jpg
case_images: PMC10894456_01_cureus-0016-00000052979-i04.jpg
case_images: FIG4
case_images: The cervicomedullary lesion measured 2 x 4 x 8 mm on 15-month surveillance imaging and 2 x 5 x 8 mm on 18-month imaging indicating a durable radiological response (Figures 2, 3, 4).