SURG-43. SURGICAL TREATMENT FOR SPINAL CORD HEMANGIOBLASTOMA - DIFFERENCE IN SURGICAL INDICATION FROM CEREBRAL HEMANGIOBLASTOMA

Abstract

Abstract Objective Spinal cord hemangioblastoma (HB) is a tumor with abundant blood flow with feeders and drainers, and is often accompanied by large cysts and syringomyelia. About 25% of HB cases are said to be von Hippel-Lindau (VHL) disease cases, which is a hereditary tumor disease. In VHL disease, multiple surgeries are often performed because HB occurs frequently. To consider whether spinal cord HB requires a different surgical indication from brain HB cases, this report analyzed the treatment results of HB cases at our hospital. Methods From 1988 to 2021, 85 patients with HB underwent surgery at our hospital investigated. Results There were16 cases of spinal cord, 58 of cerebellum, and 10 of brainstem. Of these, 46 cases (13 families, 21 patients) had VHL disease. There were 13 cases (81%) with syringomyelia and 8 cases (50%) with cysts in spinal cord HB. The mean tumor volume at spinal cord, cerebellum and brainstem were 3.2, 15.9 and 5.8 cm3, respectively. Changes in mRS before and after surgery were as follows; spinal cord HB: improvement 10 (63%)/deterioration 3 (19%), cerebellar HB: improvement 35 (60%)/deterioration 7 (12%), brainstem HB: improvement 7. (70%)/0 deterioration. In spinal cord HB, total resection was achieved in all cases, and no significant complication was observed. Conversely, 12 patients (17%) underwent shunting for postoperative hydrocephalus in cerebellum/brain stem HB. In spinal cord HB, no local recurrence was observed during the follow-up period of median 54 months (4-188 months). Conclusion Spinal cord HB was operated when the tumor volume was smaller than that of brain HB, but there was no significant difference in the symptom improvement rate. However, there were a certain number of patients who deteriorated after surgery, and it was thought that further analysis would be necessary in the future regarding appropriate surgical indications for spinal cord HB.