Romanian Neurosurgery (Nov 2024)

A CASE SERIES OF NINE PATIENTS WITH SPINAL CORD HEMANGIOBLASTOMA

  • Andrei Daniel Pirlea,
  • Alexandru-Cristian Preda,
  • Severina Andreea Batca,
  • Marius Constantin Catana

DOI
https://doi.org/10.33962/roneuro-2024-118
Journal volume & issue
Vol. 38, no. Special Issue

Abstract

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Background Hemangioblastomas are defined as benign vascular tumors, being located almost exclusively in the cerebellum, brainstem and spinal cord. Spinal cord hemangioblastomas have low frequency. Their occurrence can be associated with von Hippel – Lindau (VHL) disease, but in most cases these tumors arise sporadically. Clinical presentation is usually determined by the mass effect. Thus, gross total resection without significant neurological impairment remains a great challenge. The aim of this study was to evaluate patient outcome after surgical treatment of intramedullary hemangioblastoma. Methods The present study included nine patients who underwent surgery for intramedullary hemangioblastoma (histopatologically confirmed) at our neurosurgery clinic between January 2015 and May 2024. There were seven male and two female patients with a mean age of 43.5 years. Operation was recommended based on presence of intramedullary lesion on MR imaging and of neurological deficits, usually progressive. The neurological function was evaluated at admission, discharge and at 6 months and graded according to McCormick scale. In all cases a posterior approach via laminectomy was performed. Location, pre-surgery syringomyelia and recurrence status were also assessed through MR scans. Results Tumor localization was exlcusively intramedullary: in the cervical spinal cord in four cases, in the thoracic spinal cord in other four, and in one case it had a lumbar localization. The mean duration from symptomatology onset to surgery was 9.3 months. Presence of tumor on MR imaging was accompanied by syringomyelia in six patients (66.6 %). Complete removal was achieved in all nine cases. Three patients had VHL disease screening at the time of admission. Of those, VHL was confirmed in two. For five patients, neurological functions improved at discharge and significant improvements were reported in seven cases at 6 months in the follow-up period. Conclusion Our results showed that gross total resection was effective in improvement of clinical symptoms with a good prognosis considering recurrence rate and McCormick grade evolution at 6 months after surgery.

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