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. 2016 Jan-Mar;7(1):23-7.
doi: 10.4103/0976-3147.172165.

Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years

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Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years

Nishant Goyal et al. J Neurosci Rural Pract. 2016 Jan-Mar.

Abstract

Background: Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons.

Objective: We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS) in the management of hemangioblastomas.

Patients and methods: A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998-2011). Gamma knife plans, clinical history, and radiology were reviewed for all patients.

Results: A total of 2767 patients underwent gamma knife during the study period. Of these, 10 (0.36%) patients were treated for 24 hemangioblastomas. Eight patients (80%) had von Hippel-Lindau disease while two had sporadic hemangioblastomas. The median peripheral dose (50% isodose) delivered to the tumors was 29.9 Gy. Clinical and radiological follow-up data were available for eight patients. Of these, two were re-operated for persisting cerebellar symptoms. The remaining six patients were recurrence-free at a mean follow-up of 48 months (range 19-108 months). One patient had an increase in cyst volume along with a decrease in the size of the mural nodule.

Conclusions: SRS should be the first option for asymptomatic hemangioblastomas. Despite the obvious advantages, gamma knife is not widely used as an option for hemangioblastomas.

Keywords: Gamma knife radiosurgery; hemangioblastomas; stereotactic radiosurgery; von Hippel-Lindau syndrome.

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Figures

Figure 1
Figure 1
Axial gadolinium-enhanced magnetic resonance images of patient number 10 showing mural nodule with a small cyst (a). 1 year after radiosurgery, there was a significant decrease in the size of the mural nodule (b)
Figure 2
Figure 2
Axial gadolinium-enhanced magnetic resonance images of patient number 1 showing mural nodule with a small cyst (a). 1 year after radiosurgery, there was a decrease in the size of the mural nodule with increase in the cyst size (b) causing significant compression on the fourth ventricle

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