Diagnosis and treatment of posterior fossa solid hemangioblastoma

Objective To study the diagnosis and surgical treatment of the posterior fossa solid hemangioblastomas (PFSHs). Methods Ten patients with pathologically confirmed PFSHs admitted from 1998 to 2003 were retrospectively analyzed and relevant literatures were reviewed. Results Of the ten patients, 6 were men and 4 women. Preoperative MRI showed the tumors ranged from 3 to 5.5 cm (average 3.8 cm) in diameter. DSA inspection indicated that the tumors were primarily fed by the posterior inferior cerebellar artery. Six patients underwent preoperative embolization. Total tumor removal was achieved in 8 patients and subtotal in 2. Of the patients underwent preoperative embolization, 5 received complete resection with the intra-operation bleeding ranging from 400 to 600 ml. Two patients died of brain stem dysfunction or infection after operation. Eight patients were followed-up for 6 months to 2 years and the Glasgow outcome scale showed 5 in 7 patients and 4 in 1. Conclusion MRI and DSA are important diagnostic methods for PFSHs. Preoperative embolization may be helpful in operative excision of sensitive neural areas and allow for complete surgical resection of tumors. Microsurgery is the major treatment of choice for PFSHs and the total removal of these tumors still pose a challenge for neurosurgeons.