Hemangioblastoma and its treatment using leksell gamma knife

Between 1993 and 2006, 15 hemangioblastoma patients were treated at our department with the use of stereotactic radiosurgery. The group consisted of 8 men and 7 women aged between 14 and 72 years (mean age being 39 years). In 9 patients hemangioblastomas were associated with von Hippel-Lindau disease; in 6 patients sporadic hemangioblastomas were diagnosed. Solitary hemangioblastomas were detected in 6 multilocular in 9 patients, respectively. A total of 43 hemangioblastomas with a diameter ranging from 2 to 30 mm (the mean diameter being 10.7 mm) were irradiated. The mean tumour margin dose was 18.8 Gy (ranging from 9 to 22 Gy, the median being 20 Gy), the maximum dose into the tumour centre was 35.4 Gy (ranging from 20 to 44 Gy, the median being 36). For 13 patients, post-op follow-up results were obtained within 11 to 120 months (with the mean of 55 months and the median of 48 months). Stabilisation or improvement of clinical status was recorded for 10 patients, progression occurred in 3 patients (23 %). Among the irradiated tumours, 11 regressed and 14 showed no change in diameter, i.e. local control was attained in 80.6 % of tumours (25 out of the 31 controlled tumours). 6 irradiated tumours progressed (of which 2 due to solid part progression and 4 due to cystic part progression: stereotactic punction was performed in 3 and open neurosurgery in 1 of the 4 tumours, respectively). One patient died of extracranial organ complications associated with von Hippel-Lindau disease. Radiosurgical treatment of hemangioblastomas proved effective in patients with both solitary and multiloculary small or middle size hemangioblastomas, with a good clinical response and a low risk of complications.