Spinal cord hemangioblastomas in von hippel-lindau disease: Management of asymptomatic and symptomatic tumors

Tae Yup Kim, Do Heum Yoon, Hyun Chul Shin, Keung Nyun Kim, Seong Yi, Jae Keun Oh, Yoon Ha

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5 Citations (Scopus)

Abstract

Purpose: Standard treatment of asymptomatic spinal cord hemangioblastoma in von Hippel-Lindau (VHL) disease has yet to be established. The purpose of this study was to propose guidelines for the treatment of asymptomatic spinal cord hemangioblastomas in VHL disease. Materials and Methods: VHL disease patients treated for spinal cord hemangioblastomas between 1999 and 2009 were included. All spinal cord hemangioblastomas were divided into three groups: Group 1, asymptomatic tumors at initial diagnosis followed with serial imaging studies; Group 2, asymptomatic tumors at initial diagnosis that were subsequently resected; and Group 3, symptomatic tumors at initial diagnosis, all of which were resected. Results: We identified 24 spinal cord hemangioblastomas in 12 patients. Groups 1, 2 and 3 comprised 13, 4 and 7 tumors, respectively. Group 1 exhibited a smaller tumor volume (257.1 mm3) and syrinx size (0.8 vertebral columns) than those of Group 2 (1304.5 mm3, 3.3 vertebral columns) and Group 3 (1787.4 mm3, 6.1 vertebral columns). No difference in tumor volume or syrinx size was observed between Groups 2 and 3. Five tumors in Group 1 were resected during follow-up because symptoms had developed or the tumor had significantly grown. Finally, among 17 asymptomatic tumors at the initial diagnosis, nine tumors were resected. Only one tumor of these nine tumors resulted in neurological deficits, while five of seven symptomatic tumors caused neurological deficits. Conclusion: Selective resection of asymptomatic tumors before they cause neurological deficits might bring about better outcomes.

Original languageEnglish
Pages (from-to)1073-1080
Number of pages8
JournalYonsei medical journal
Volume53
Issue number6
DOIs
Publication statusPublished - 2012 Nov

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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