Hemangioblastoma of the posterior fossa: the role of multimodality treatment

Abstract

The authors made a review of a series of patients with hemangioblastomas of the posterior fossa treated between 1973 and 1993. A total of 32 patients were analyzed with 24 patients receiving resection, 8 paticnts receiving radiosurgery and 2 patients receiving conventional radiotherapy. The mortality in lhe patients with a resection was considered acceptable with 2 deaths (8%) and with a morbidity of 3 patients (12.5%). A review of the literature suggests that convcntional radiothcrapy with high doses (45-60 Gy) may have a role in lhe post-operative control of hemangioblastoinas and in some cases could he employed evcn beforc lhe resection in orderto facililate lhe surgery. The radiosurgical treatment is regarded like adjuvant. Poor results were ohtained with radiosurgery in large tumors where low doses (less than 20 Gy) were used. Bccausc of lhe rarity and complexity of these tumors, mainly when associated with voo Hippel-Lindau disease, a multicenter study could he useful with lhe a.ssessment of lhe optimal utilization and combination of these treatment modalities.