Treatment Strategies for Cerebellar Hemangioblastomas: Simple or Further Studies?

Jito, Junya; Nozaki, Kazuhiko

doi:10.1016/j.wneu.2014.08.018

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…Multiple feeding arteries are often present, as well as more than one abnormally thick draining vein, with large diameters and thick walls (9), which were identified in the two patients of the present cases. Occasionally, a localized flow and rich blood supply within the tumor is observed and the color of intravenous blood is bright red (9), which occurred in the present cases. However, caution must be taken not to block the draining veins mistakenly based on the color of the blood, as this may result in heavy bleeding due to the venous return obstruction.…”

Section: Discussionsupporting

confidence: 52%

“…However, for this type of lesion, the tumor must not be punctured, biopsied or blocked via resection due to the rich blood supply. The enhanced tumor wall indicates that it contains partial tumor cells, therefore to avoid recurrence of the tumor, the wall and the solid part of the tumor require total resection (9). This type of tumor has a benign characteristic, and is generally located in the brain parenchyma (9).…”

Section: Discussionmentioning

confidence: 99%

“…The enhanced tumor wall indicates that it contains partial tumor cells, therefore to avoid recurrence of the tumor, the wall and the solid part of the tumor require total resection (9). This type of tumor has a benign characteristic, and is generally located in the brain parenchyma (9). However, tumors may perforate the surface of the brain and metastasize to the surrounding regions (10).…”

Section: Discussionmentioning

confidence: 99%

“…However, tumors may perforate the surface of the brain and metastasize to the surrounding regions (10). Following complete resection, it is unlikely that the tumor will recur, and therefore chemotherapy or radiotherapy is not frequently required (9). Even in cases where residual tumors are identified, only a small number of these tumors become malignant.…”

Section: Discussionmentioning

confidence: 99%

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Surgical resection of cerebellar hemangioblastoma with enhanced wall thickness: A report of two cases

Sun¹,

Yuan²,

Sun³

et al. 2015

Oncology Letters

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Abstract. Hemangioblastomas are tumors of the central nervous system, and the cerebellum is the most common site of occurrence. Cerebellar hemangioblastoma with enhanced wall thickness is rare and often misdiagnosed preoperatively. At present, no unified radiological classification system based on magnetic resonance imaging (MRI) findings exists for cerebellar hemangioblastoma, and this tumor type can be solid or cystic mass, according to the MRI findings. The most common presentation of cerebellar hemangioblastoma observed radiologically is a large sac with small nodules, where the wall of the large cyst is not enhanced. A tumor with enhanced large cysts and tumor nodules is extremely rare. The most effective treatment is complete resection of the cyst and the solid growth. The present case reports the successful treatment of two cases of cerebellar hemangioblastoma with enhanced wall thickness, including the MRI findings for the differential diagnoses and the surgical experiences. IntroductionHemangioblastomas are tumors of the central nervous system that most frequently arise from the vascular system; they are classed as is WHO grade I tumors (1). In adults, 7-10% of tumors arise in the posterior fossa (2) and the cerebellum is the most common site of occurrence (3,4). As a number of features may be observed on magnetic resonance imaging (MRI), (1,(3)(4)(5)(6) according to previous reports, cerebellar hemangioblastoma can be predominantly divided into two categories on the basis of MRI findings. The most common radiological presentation of cerebellar hemangioblastoma is a large sac or cyst and small tumor nodules. We hypothesize that this type may be further divided into two subtypes: One which exhibits no enhancement at the wall of the large cyst, but with evenly enhanced tumor nodules; and another with an enhanced large cyst and tumor nodules. The less common type of cerebellar hemangioblastoma is a solid mass, and also comprises two subtypes: One type contains multiple solid tumors and exhibits homogeneous enhancement on MRI; the other subtype is a solid tumor with single or multiple cysts, where the solid portion is enhanced and the cystic region is non-enhanced (7). In addition to the two main tumor types, the rarest variant of this tumor exhibits an enhanced cyst wall, based on the cystic nodules, and is accompanied by enhanced uneven walls (6). The first type (a large sac or cyst with small tumor nodules) has surrounding edema. The other two types (one type is a solid mass, one type exhibits enhanced cyst wall) exhibit an obvious mass and do not have surrounding edema. However, in spite of these characteristic features on imaging, in the preoperative and differential diagnoses, solid cerebellar hemangioblastoma and nodular cerebellar hemangioblastoma with enhanced wall are often misdiagnosed as high-grade gliomas (6).For cerebellar hemangioblastoma with an enhanced cystic wall, surgical resection is the most effective treatment. The tumor is unlikely to recur following complete resection, therefore che...

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical resection of cerebellar hemangioblastoma with enhanced wall thickness: A report of two cases

Sun¹,

Yuan²,

Sun³

et al. 2015

Oncology Letters

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“…They preferentially occurs in middle-age people, majority in the fourth and fifth decades, with no gender predilection [1]. Approximately 75% of hemangioblastomas occur in sporadic form, but there are still a small number of patients associated with Von Hippel-Lindau (VHL) disease [2]. The symptoms or signs of sporadic hemangioblastomas includes headache, vertigo, blurred vision, nausea or vomiting, extremity paresis, decreased hearing, facial paresthesia and consciousness diaturbance [3], and it varies according to the specific tumor location and tumor size.Based on neuroimaging appearances, hemangioblastomas can be divided into three patterns: one is a large unenhanced cyst with small enhanced tumor nodules, the other two are solid enhanced…”

mentioning

confidence: 99%

A cystic ring-enhancing cerebellar lesion

Wang¹,

Liu²,

Cheng

et al. 2017

Journal of Clinical Neuroscience

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Considering the patient's MRI appearance, astrocytoma seems the correct choice at first glance. But in fact, postoperative histopathologic examination demonstrated the diagnosis of hemangioblastoma (Fig. 2C). This is an especially rare neuroradiologic manifestation of cerebellar hemangioblastoma, with enhanced cystic wall in Gd-enhanced MRI sequences; and her CT angiographic with abnormal vessels on the surface of the cystic mass may explain this rare phenomenon (Fig. 2A).Hemangioblastomas comprise 2% of all intracranial tumors, and 7-10% of posterior fossa tumors, with a predilection of cerebellum, brainstem and the spinal cord. They preferentially occurs in middle-age people, majority in the fourth and fifth decades, with no gender predilection [1]. Approximately 75% of hemangioblastomas occur in sporadic form, but there are still a small number of patients associated with Von Hippel-Lindau (VHL) disease [2]. The symptoms or signs of sporadic hemangioblastomas includes headache, vertigo, blurred vision, nausea or vomiting, extremity paresis, decreased hearing, facial paresthesia and consciousness diaturbance [3], and it varies according to the specific tumor location and tumor size.Based on neuroimaging appearances, hemangioblastomas can be divided into three patterns: one is a large unenhanced cyst with small enhanced tumor nodules, the other two are solid enhanced

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The analysis of correlative factors affecting long-term outcomes in patients with Solid Cerebellar Hemangioblastomas

Niu

Zhang

Liao

et al. 2016

Clinical Neurology and Neurosurgery

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Treatment Strategies for Cerebellar Hemangioblastomas: Simple or Further Studies?

Cited by 7 publications

References 10 publications

Surgical resection of cerebellar hemangioblastoma with enhanced wall thickness: A report of two cases

Surgical resection of cerebellar hemangioblastoma with enhanced wall thickness: A report of two cases

A cystic ring-enhancing cerebellar lesion

The analysis of correlative factors affecting long-term outcomes in patients with Solid Cerebellar Hemangioblastomas

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