Clinical features and surgical outcomes of sporadic cerebellar hemangioblastomas

Sporadic hemangioblastomas show a strong preference for the cerebellum. We clarify the clinical characteristics and role of surgery in sporadic cerebellar hemangioblastomas.

This 11-year retrospective study enrolled 20 patients (10 men and 10 women; 41.6±9.8 years) with sporadic cerebellar hemangioblastomas. All patients had a solitary tumor and underwent surgical resection of the lesion through a suboccipital midline approach. The basic features, serial radiographic examinations, and operative records were analyzed.

The mean follow-up was 39.2±37.4 months (range, 2-134 months). The most common presenting symptoms were headache, vertigo, ataxia, and nausea or vomiting. There were 6 (30.0%) completely solid, 1 (5.0%) combined solid and cystic, and 13 (65.0%) primarily cystic tumors. The average size of the tumor was 40.7±8.7mm in its maximal diameter (range, 25-58mm). Eighteen (90.0%) patients underwent gross total resection and 2 (10.0%) underwent partial resection. After the primary surgery, 16 (80.0%) patients experienced improvement in their symptoms, 4 (20.0%) maintained their pretreatment status, and none showed neurological deterioration following tumor resection. Recurrence and progression were identified in 4 of 20 tumors. Three of the 4 tumors became symptomatic and the patients underwent secondary surgery with total removal of the tumor.

Sporadic cerebellar hemangioblastomas are usually associated with cysts and are voluminous by the time of diagnosis. Because these tumors result in the mass effect of posterior fossa, surgical removal is preferable and safe, and can be a timely curative strategy to prevent neurological decline.