Relationship between Spinal Hemangioblastoma Location and Age

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the relationship between tumor location and clinical characteristics. OVERVIEW OF LITERATURE: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma's location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI. METHODS: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma. Using T1 contrast axial MRI data, the cases were divided into three groups (intramedullary, intramedullary+extramedullary, and extramedullary). Patient demographics, MRI findings, and preoperative neurological status were analyzed and compared for each group. RESULTS: The average age of patients with intramedullary, intramedullary+extramedullary, and extramedullary hemangioblastoma was 34.0, 64.4, and 67.5 years, respectively. Patients in the intramedullary hemangioblastoma group were younger than the other groups. Extramedullary cases had a smaller syrinx compared to the other groups. CONCLUSIONS: Age may play an important role in the hemangioblastoma tumor location and the subsequent diagnosis by an MRI.

Solitary Hemangioblastoma at the Filum Terminale: A Case Report and Review of Literature

Spinal hemangioblastomas at the filum terminale are rare. Only a few reports present immunohistopathological features of spinal hemangioblastomas. A 55-year-old woman presented with sustained low back pain and intermittent numbness in both lower extremities. She already had a decompressive surgery for a left L5-S1 extraforaminal lesion 7 months ago. Her incidental mass lesion had been slightly enlarged for 7 months and concordant symptoms had also been prolonged. Her tumor was removed en bloc with a unilateral hemilaminotomy and bilateral decompression technique. The patient's symptoms improved immediately after the surgery. In immunohistochemical stains, the stromal cells were positive for inhibin-alpha, neuron specific enolase (NSE), and the endothelial cells were positive for CD31, CD34, and factor VIII related antigen in confirming the diagnosis of hemangioblastoma. We report a rare case of intradural extramedullary spinal hemangioblastoma at the filum terminale. Complete en bloc resection was achieved with no morbidity. The immunohistopathological staining include inhibin-alpha confirmed an accurate diagnosis of the hemangioblastoma distinguishing from other vascular tumors.

Intramedullary Spinal Hemangioblastoma Associated with Syringomyelia

Intrameduallary spinal hemangioblastoma is frequently associated with syringomyelia. It grows slowly and can be removed totally. Syringomyelia can be subcided by total removal of tumor and opening of syringomyelia. Two cases of intramedullary spinal hemangioblastomas associated with syringomyelia are reported. Intramedullary tumor and syrinx was easily diagnosed by magnetic resonance imaging(MRI). They are successfully managed by total removal of tumor and opening of syrinx. Patients showed improved neurological status after operations.