Lorenzo Giammattei1,2, Mahmoud Messerer3,4, Nozar Aghakhani3, Philippe David3, Anne Herbrecht3, Stéphane Richard5, Fabrice Parker3. 1. Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France. lore1985nch@gmail.com. 2. Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", Via. G. Celoria 11, Milan, 20133, Italy. lore1985nch@gmail.com. 3. Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France. 4. Département de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland. 5. Laboratoire de Génétique Oncologique EPHE, CHU de Bicêtre, Le Kremlin-Bicêtre, France.
Abstract
OBJECT: The purpose of this study was to analyze the surgical outcome and complications of a single-center series of medulla oblongata (MO) hemangioblastomas. METHODS: We retrospectively reviewed the medical charts of all medulla oblongata hemangioblastomas operated on at our institution between 1996 and 2015. All patients had a pre- and postoperative MRI and a minimum follow-up of 6 months. Patients were scored according to the Karnofsky Performance Scale (KPS) and McCormick Scale at the moment of admission, discharge and the last follow-up. RESULTS: Thirty-one surgical procedures were performed on 27 patients (16 females and 11 males). The mean age was 33 years, and 93 % of patients had von Hippel Lindau (VHL) disease. Three patients experienced very complicated postoperative courses, with one case ending in the death of the patient. Two patients required tracheostomy. According to McCormick's classification, 7 (23 %) of the 31 operations resulted in aggravation and 23 (74 %) in no change. Considering the seven patients with aggravation at discharge, four patients (60 %) returned to their preoperative status, one (14 %) improved but remained below his preoperative McCormick grade and two (29 %) did not improve. At last follow-up, KPS was ameliorated in 53 %, stable in 40 % and worsened in 7 % of cases. CONCLUSION: Surgery of medulla oblongata hemangioblastomas is a challenging procedure characterized by an acceptable morbidity. Transient morbidity is not negligible even if the long-term outcome is in most cases favorable. A compromised neurological condition seems to be the best predictor of unfavorable outcome.
OBJECT: The purpose of this study was to analyze the surgical outcome and complications of a single-center series of medulla oblongata (MO) hemangioblastomas. METHODS: We retrospectively reviewed the medical charts of all medulla oblongata hemangioblastomas operated on at our institution between 1996 and 2015. All patients had a pre- and postoperative MRI and a minimum follow-up of 6 months. Patients were scored according to the Karnofsky Performance Scale (KPS) and McCormick Scale at the moment of admission, discharge and the last follow-up. RESULTS: Thirty-one surgical procedures were performed on 27 patients (16 females and 11 males). The mean age was 33 years, and 93 % of patients had von Hippel Lindau (VHL) disease. Three patients experienced very complicated postoperative courses, with one case ending in the death of the patient. Two patients required tracheostomy. According to McCormick's classification, 7 (23 %) of the 31 operations resulted in aggravation and 23 (74 %) in no change. Considering the seven patients with aggravation at discharge, four patients (60 %) returned to their preoperative status, one (14 %) improved but remained below his preoperative McCormick grade and two (29 %) did not improve. At last follow-up, KPS was ameliorated in 53 %, stable in 40 % and worsened in 7 % of cases. CONCLUSION: Surgery of medulla oblongata hemangioblastomas is a challenging procedure characterized by an acceptable morbidity. Transient morbidity is not negligible even if the long-term outcome is in most cases favorable. A compromised neurological condition seems to be the best predictor of unfavorable outcome.
Entities:
Keywords:
Hemangioblastoma; Medulla oblongata; Surgical treatment; Von Hippel-Lindau syndrome
Authors: Ha Son Nguyen; Ninh B Doan; Michael Gelsomino; Saman Shabani; Ahmed J Awad; Mayank Kaushal; Martin M Mortazavi Journal: Oncotarget Date: 2018-06-15