Sporadic Spinal Hemangioblastomas Can be Effectively Treated by Microsurgery Alone

Sun, Hui; Özduman, Koray; Usseli, Murat İmre; Özgen, Serdar; Pamir, M. Necmettin

doi:10.1016/j.wneu.2014.05.024

Cited by 37 publications

(30 citation statements)

References 13 publications

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“…[13456789101112131415161718192021] The median age is 45 years (range = 24–72 years). The female:male ratio is 0.6.…”

Section: Resultsmentioning

confidence: 99%

“…[13] More than half of the patients with spinal nerve root hemangioblastoma were found to have concomitant VHL disease. [11] However, in this study, concomitant VHL disease rate has been found as only 45%.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical experience is the mainstay of success in excision of these tumors. [13] There is a tendency to recur especially in cases with an inadequate amount of resection. [12]…”

Section: Discussionmentioning

confidence: 99%

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Purely extradural spinal nerve root hemangioblastomas

Aytar

Yener

Ekşi

et al. 2016

J Craniovert Jun Spine

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Spinal nerve root hemangioblastomas present mostly as intradural-extradurally. Purely extradural spinal nerve root hemangioblastoma is a very rare entity. In this study, we aimed to analyze epidemiological perspectives of purely extradural spinal nerve root hemangioblastomas presented in English medical literature in addition to our own exemplary case. PubMed/MEDLINE was searched using the terms “hemangioblastoma,” “extradural,” “spinal,” and “nerve root.” Demographical variables of age, gender, concomitant presence of von Hippel–Lindau (VHL) disease; spinal imaging and/or intraoperative findings for tumor location were surveyed from retrieved articles. There are 38 patients with purely extradural spinal nerve root hemangioblastoma. The median age is 45 years (range = 24–72 years). Female:male ratio is 0.6. Spinal levels for purely extradural spinal nerve root hemangioblastomas, in order of decreasing frequency, are thoracic (48.6%), cervical (13.5%), lumbar (13.5%), lumbosacral (10.8%), sacral (8.1%), and thoracolumbar (5.4%). Concomitant presence of VHL disease is 45%. Purely extradural spinal nerve root hemangioblastomas are very rare and can be confused with other more common extradural spinal cord tumors. Concomitant presence of VHL disease is observed in less than half of the patients with purely extradural spinal nerve root hemangioblastomas. Surgery is the first-line treatment in these tumors.

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“…[13456789101112131415161718192021] The median age is 45 years (range = 24–72 years). The female:male ratio is 0.6.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Purely extradural spinal nerve root hemangioblastomas

Aytar

Yener

Ekşi

et al. 2016

J Craniovert Jun Spine

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“…In man, radiation therapy does not improve outcome for intramedullary tumors; cases of hemangioblastoma had prolonged remission without radiation or chemotherapy across many studies . Stereotactic radiosurgery is an alternative to surgery for human hemangioblastoma, but surgery is the treatment of choice …”

Section: Discussionmentioning

confidence: 99%

Remission after complete excision of an intramedullary hemangioma with an identifiable tumor plane in a dog

et al. 2019

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Objective To describe the use of an identifiable tumor plane (ITP) during myelotomy to excise an intramedullary hemangioma in a dog and report the outcome. Study design Case report. Animals One 5.5‐year‐old 42.9‐kg spayed female Leonberger dog. Methods Clinical signs included progressive proprioceptive deficits of both pelvic limbs. Magnetic resonance imaging was consistent with a dorsal intramedullary mass at L3‐L4. A laminectomy of the third and fourth lumbar vertebrae provided access for dorsal myelotomy. A clear surgical ITP was identified between the intramedullary mass and the spinal cord facilitating complete surgical resection. Results Histopathological examination was consistent with a hemangioma. Postoperative MRI was consistent with complete excision of the mass. No evidence of recurrence was found by MRI at 3 months and at 22 months after surgery. Mild proprioceptive deficits persisted in the right pelvic limb. Conclusion A clear ITP was present, and gross‐total resection (GTR) was achieved without significant morbidity. Persistent clinical remission resulted from surgery as the sole therapy. Clinical significance For an intramedullary tumor, GTR is the absence of visible tumor on intraoperative inspection combined with the absence of intramedullary contrast enhancement on postoperative MRI. When an ITP is present, GTR and resultant long‐term remission may be more likely.

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“…10 Due to the vascularity of the lesion, resection does pose a risk of intraoperative bleeding; however, recent studies have shown that hemorrhage from feeder arteries is generally not an issue due to techniques such as preoperative embolization and temporary artery occlusion. 66 Therefore, resection appears to be the best option for patients with hemangioblastoma.…”

Section: Hemangioblastomasmentioning

confidence: 99%

Intramedullary spinal cord tumors: a review of current and future treatment strategies

Tobin¹,

Geraghty²,

Engelhard³

et al. 2015

FOC

139

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Intramedullary spinal cord tumors have low incidence rates but are associated with difficult treatment options. The majority of patients with these tumors can be initially treated with an attempted resection. Unfortunately, those patients who cannot undergo gross-total resection or have subtotal resection are left with few treatment options, such as radiotherapy and chemotherapy. These adjuvant treatments, however, are associated with the potential for significant adverse side effects and still leave patients with a poor prognosis. To successfully manage these patients and improve both their quality of life and prognosis, novel treatment options must be developed to supplement subtotal resection. New research is underway investigating alternative therapeutic approaches for these patients, including directed, localized drug delivery and nanomedicine techniques. These and other future investigations will hopefully lead to promising new therapies for these devastating diseases.

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Sporadic Spinal Hemangioblastomas Can be Effectively Treated by Microsurgery Alone

Cited by 37 publications

References 13 publications

Purely extradural spinal nerve root hemangioblastomas

Purely extradural spinal nerve root hemangioblastomas

Remission after complete excision of an intramedullary hemangioma with an identifiable tumor plane in a dog

Intramedullary spinal cord tumors: a review of current and future treatment strategies

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