Clinical features and surgical outcomes in patients with cerebellopontine angle hemangioblastomas: a retrospective series of 23 cases.

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Clinical features and surgical outcomes in patients with cerebellopontine angle hemangioblastomas: a retrospective series of 23 cases.

World Neurosurg. 2017 Apr 08;:

Authors: Cheng J, Liu W, Zhang S, Lei D, Hui X

Abstract
OBJECTIVE: Hemangioblastomas in the cerebellopontine angle (CPA) are uncommon and have rarely been reported. They may be easily misdiagnosed because of the atypical location, clinical and imaging features. The present study aimed to characterize clinical and radiological features, treatment strategies and outcomes in these rare lesions and to investigate various factors that may affect postoperative outcomes.
METHODS: The medical records of patients with CPA hemangioblastomas who underwent surgery from 2003 to 2016 at the West China Hospital were reviewed retrospectively and statistically analyzed.
RESULTS: Twenty-three patients (14 males and 9 females) presented with CPA hemangioblastomas. Eight patients (34.8%) had VHL syndrome. Gross total resection was achieved in 22 patients (95.6%). The mean follow-up was 45.1±36.2 months (range 3-144 months). After surgery, the symptoms improved in 18 cases (78.3%), remained unchanged in 3 cases (13%), and were aggravated in 2 cases (8.7%). Four patients showed the local recurrence during the follow-up (17.4%). Patients with cystic hemangioblastomas had a better neurological improvement (P=0.041) compared with patients with solid tumors. Furthermore, patients with maximal diameter of tumors larger than 3 cm (P=0.035) or solid tumors (P=0.018) showed a higher incidence of postoperative complications. The local recurrence was correlated with VHL disease (p=0.027).
CONCLUSIONS: Although hemangioblastomas of the CPA are challenging lesions to treat surgically, they can be removed safely when these lesions are appropriately diagnosed and treated. Patients with VHL disease are more likely to have a local recurrence. A regular follow-up is recommended to detect the local and distant recurrence, even if the clinical course is benign and tumor is totally resected.

PMID: 28400229 [PubMed - as supplied by publisher]

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