Surgical treatment for hemangioblastomas in the medulla oblongata

Abstract

Surgery is the first-line treatment for symptomatic patients with hemangioblastomas in the medulla oblongata. Good results can be achieved for the cystic or small solid tumors. Large solid tumors remain a surgical challenge due to arteriovenous malformation-like vascularization. Preoperative embolization is useful for large solid tumors. For asymptomatic tumors, careful long-term observation or radiosurgery could be chosen.

Neurosurgical Management of Brainstem Hemangioblastomas: A Single-Institution Experience with 116 Patients

“…In this situation, it is dangerous to completely remove the tumor without risking brainstem injury. With our experience, it is very important to minimize compression or damage to the adjacent brainstem by rotating or retracting the tumor as far as possible (39,42). With circumferential dissection proceeding deeper, and feeding arteries being coagulated as close to the margin of the tumor, the tension of the tumor is relaxed and the volume of the tumor is shriveled.…”

“…Recent excellent results with acceptable complications in some neurosurgical centers is promising (6,(38)(39)(40)(41)(42), although no randomized clinical trials have been done to compare the complications of microsurgery and radiosurgery. Our long-term follow-up data showed no tumor recurrence in situ after total tumor excision regardless of whether the lesions are sporadic or VHL-disease type (83/107).…”

“…From January 1994 to December 2013, a total of 116 consecutive solitary brainstem HB patients underwent surgery by the senior authors in the Huashan Hospital (part of the cases had been previously reported (39,42)). Clinical information was obtained from hospital charts, clinic notes, and operative reports.…”

Safety and efficacy of surgical treatment for brainstem hemangioblastoma: a meta-analysis

“…Consequently, surgical treatment for brainstem hemangioblastoma poses a significant challenge for neurosurgeons. To date, there have been many studies on the surgical outcomes of microsurgical resection of brainstem hemangioblastomas [4,10,13,15,17,22,[33][34][35][36][37][38]40]. We conducted a meta-analysis of surgical outcomes from the published literature to evaluate the safety and efficacy of surgical treatment for brainstem hemangioblastoma in this study.…”

Treatment strategy for the tumor cyst of the medulla in an eloquent area: a case report and review of the literature

“…Вибір тактики лікування (спостереження за пухлиною, мікрохірургічне лікування чи радіохірургія) хворих з кістозно-солідними гемангіобластомами стовбура головного мозку є актуальним і невирішеним питанням [3].…”