Solid vs. cystic predominance in posterior fossa hemangioblastomas: implications for cerebrovascular risks and patient outcome

Multimodal management of giant solid hemangioblastomas in two patients with preoperative embolization

“…The symptoms in more than 50% of patients are intracranial hypertension, and one-third of patients present cerebellar signs,[ 8 , 11 ] as is the case of our patients, who developed obstructive hydrocephalus in the first instance, which was the source of the symptoms, a ventriculoperitoneal shunt was placed first.…”

“…Hemangioblastomas are benign WHO grade 1 tumors [ 9 , 11 , 20 ], and 60 to 75% of hemangioblastomas occur spontaneously, while 25–40% are associated with von Hippel-Lindau disease. [ 11 , 14 ] The peak incidence is between the fifth and sixth decade of life,[ 11 ] but none of our cases are within this peak incidence. Jeon et al .…”

“…found in their study a high rate of aneurysms associated with hemangioblastoma, unlike those described in the literature, hypothesizing that it could be due to flow and could resolve after tumor surgery. [ 11 ]…”

“…Surgical resection is the management of choice due to its location in the posterior fossa, large size, and high vascularization, and preoperative embolization is not always a requirement. [ 1 , 11 ] Moscovici et al . mention in their study that solid and cystic hemangioblastomas should be treated as two different entities since cystic ones have easier management due to their small solid component, the same cyst can give access to the solid component, and drainage of the cyst relaxes the cerebellum giving better access.…”

“…Intracranial hemangioblastomas are benign vascular neoplasms, considered World Health Organization (WHO) grade I, developing mostly in the posterior fossa; the usual locations are the cerebellum (44–72%), spinal cord (13–44%), and brainstem (1–6%). [ 1 , 9 , 11 , 20 ]…”