 and presenting a case with vote on radiological manifestations of one hippal in Dowson Dome. Clinical history, a 41-year-old male without a significant past medical history, presented to Oberhospital, complaining of 15 days history of vomiting and abdominal pain. Physical examination was unremarkable. Root and lab investigations were within normal limits, including blood counts, venal and liver function tests. Imaging findings, ultrasound of a prominent pelvis remonstrated, bilateral multiple simple venous cysts, multiple simple liver cysts and bilateral large adrenal masses. So, in the first image here we can see a well-defined smooth fault puce cyst noted in both lobsters of liver, such as stroke simple liver cyst. In the second image, there is a well-defined smooth fault puce cysts are noted in both the kidneys such as stroke simple renal cyst. In the third image, there is a well-defined heterogeneous soft tissue lesion predominantly hypoechoic noted between the spleen and left kidney. Left kidney is not shown here. It is most likely suggestive of adrenal mass. In the fourth image, there is a well-defined heterogeneous predominantly hypoechoic soft tissue lesion noted between the liver and right kidney, most likely suggestive of adrenal mass. Subsequently, a contrast enhanced CT abdomen demonstrated multiple thin wall cysts lesions of varying sizes noted in both kidneys consistent with bilateral simple renal cyst. Second, multiple thin wall cysts lesions of varying sizes noted in both lobsters of liver consistent with simple liver cyst. And third, heterogeneous reenancing bilateral adrenal masses, most likely suggestive of bilateral pure homocytonous. So here we can see there is a multiple well-defined smooth fault cystic lesions are noted in both lobsters of liver. In the second image, there is a bilateral adrenal masses seen on the right side. Adrenal masses somewhat heterogeneous and there is a hypodensity seen within the lesion suggestive of necrosis. Again, we can see there is a bilateral renal cystic lesions and a liver simple cyst. And also there is a bilateral adrenal masses. A contrast in our summary of pre-postural demonstrating a cystic lesion in the inferior aspect of cerebral hemisphere with an enhancing solid component. This lesion is likely represent hemangioblastoma. Discussion, von Eppel-Lindau syndrome is an autosomal dominant inherited neoplasmic disorder that demonstrates age-dependent penetrates and mapenotypic variability. The basic underlying abnormality is mutation in VHL tumor separation gene, located on the short arm of chromosome number three. The tumors are initiated by VHL inactivation and are associated with abnormal activation of hypoxic gene response pathway. The most frequent tumor are retinal and CNS imangioblastoma followed by a clear cell RCC, pleochromocytoma, pancreatic eyelids tumors and endolymphantic sac tumors. In addition, renal and pancreatic cysts as well as epididymol or broad ligament cysts terrenomas also occur. All of the tumors that are typically found in VHL disease can occur as a sporadic event. So, a clinical diagnosis of VHL disease in a patient with a positive family history requires the presence of two tumors. Example two hemangioblastomas or a hemangioblastoma and a visceral tumor. All those specific gene mutations can be demonstrated. Diagnosis is generally clinical and depends primarily on the imaging. Location-wise, patients may develop some or all of the various regions which includes abdominal pelvis region. Their renal is most common which includes renal and carcinoma, renal cyst and renal angioma lipooma. Promises renal cell carcinoma are most common. The second is adrenals. Adrenals where piochromocytoma or extraadrenals piochromocytoma can be seen where piochromocytoma is 25 to 30 percent common. In pancreas, maybe represented earlier and pancreatic cysts are most common. P-net can be seen usually non-functional and frequently multiple can be seen in 9 to 17 percent of patients. Pancreatic serial cyst adrenoma or pancreatic adrenal carcinoma can be seen. In liver, liver cysts are more common. Neurogenitally, there is epididymal cyst can be present. Brot ligament cyst adrenomas can be present. In CNS, 70 percent of patients may be presented with a CNS menjoblastomas where the most common site is cerebellar or second most common is spinal cord or can be seen in brainstem. Pio presented here classical case of rare P-HR syndrome. C-C-T abdomen were consistent with bilateral piochromocytomas, liver and renal cysts. MRF findings were consistent with hemangioblastoma of left cerebellar hemisphere. Imaging findings confirmed the diagnosis of P-HR syndrome. Therefore, serum and urinary cataclylamides levels were done for screening of piochromocytomas and were found to be risk. The patient is now being worked up for a section of piochromocytomas and hemangioblastomas and for the follow planning was made. Treatment, primary treatment of all vaginal related tumors is global. For example, surgical resection, RFA or radiotherapy. Systemic treatment is recommended in the metastatic settings addressing the same therapeutic principles as in the sporadic malignancies. Due to the reality of VHL data about systemic treatments are sparse. PEGF targeting agent seems to be reasonable choice with regards to the panthopysiology in most of the tumors. High levels of PEGF are found in hemangioblastoma and it has been hypothesized that blocking the PEGF pathway might result in disruption of the tumor angiogenesis and consequently tumor regression. Conclusion, early diagnosis and application of recommended screening program for VHL is of utmost importance to prevent early morbidity and mortality. Local therapeutic approaches are the means of tumor treatment and should be provided by experienced physician with the widespread knowledge of VHL disease. Further understanding of pathopysiology and consequences of VHL gene mutations may guide further targeted therapies. Even if all symptomatic such patients should be followed to detect new lesions and to monitor the progression of new lesions. Follow-up evaluation focuses on hemangioblastomas and endolympathic sac tumors, pyrchromocytomas, pyrcell RCC, and pancanetic study tumors as well as regions of epididymis and broad pigment of uterus and can be tailored to individual patient needs. Thank you.