Sporadic and Von-Hippel Lindau disease-associated spinal hemangioblastomas: institutional experience on their similarities and differences

Yousef A., Rutkowski M. J., Yalcin C. E., Eren Ö. C., Caliskan I., Tihan T.

JOURNAL OF NEURO-ONCOLOGY, cilt.143, sa.3, ss.547-552, 2019 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 143 Sayı: 3
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1007/s11060-019-03189-w
  • Dergi Adı: JOURNAL OF NEURO-ONCOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.547-552
  • Anahtar Kelimeler: Hemangioblastoma, Von Hippel-Lindau, Spine, Neuro-Oncology, Spinal hemangioblastoma, CENTRAL-NERVOUS-SYSTEM, SURGICAL-MANAGEMENT, CORD HEMANGIOBLASTOMAS, INTRAMEDULLARY HEMANGIOBLASTOMA, CLINICAL-FEATURES, NATURAL-HISTORY
  • Marmara Üniversitesi Adresli: Hayır

Özet

IntroductionHemangioblastomas are uncommon tumors of the central nervous system that can be seen in Von Hippel-Lindau (VHL) disease. Despite their benign histology, hemangioblastomas can cause substantial morbidity due to involvement of critical structures. In order to better understand the clinical behavior of spinal cord hemangioblastomas, we have analyzed the clinical, pathologic, radiologic characteristics and management of sporadic and VHL-associated cases at our institution.MethodsWe performed a database search to identify all spinal hemangioblastomas at our institution between 1997 and 2016. Tumor characteristics were analyzed for sporadic and VHL-associated tumors separately in order to understand the differences in groups.ResultsWe included 20 patients with VHL-associated spinal hemangioblastomas, and 22 patients with sporadic spinal hemangioblastomas. VHL-associated patients were significantly younger at time of presentation compared to sporadic patients (p<0.0025). Thirty-two patients (76.2%) presented with focal weakness, 34 (81.0%) with sensory loss, and 22 (52.4%) with pain. VHL patients were more likely to present with multiple symptoms (p<0.001). Median follow-up time was 20.9months, during which 17 tumors recurred. The median recurrence free interval was 44months. There were no differences in gross total resection rates between sporadic and VHL-associated cases (p=0.197). VHL-associated cases had a higher rate of repeat surgery for recurrence (14 patients-73.6%) compared to sporadic cases (3 patients-13.6%; p<0.001).ConclusionVHL-associated spinal hemangioblastomas differ from sporadic tumors in terms of age, presenting symptoms, multifocality, and rate of recurrence. Recurrences seem to be unrelated to the extent of resection, indicating the need for life-long follow up for VHL patients.