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A hemangioblastoma is a benign vascular tumor located along the spine. Although these tumors are benign, they can cause significant neurological problems, depending on their location. Hemangioblastomas are rare, accounting for only three percent of all spinal tumors. Most occur as a single tumor, but some patients develop hemangioblastomas as part of a genetic cancer syndrome called von Hippel-Lindau (VHL) disease. These patients develop multiple tumors within the brain and spinal cord over the course of a lifetime.
At UPMC, we treat hemangioblastomas with surgery to remove the tumor (resection) or stereotactic radiosurgery, which uses highly focused radiation beams to target and destroy tumors in a single session. Radiosurgery is noninvasive, but may take from six months to a year to destroy a hemangioblastoma. If a tumor is large and causing significant neurological symptoms, surgical resection is usually preferred.
Because spinal hemangioblastomas are rare and have some of the same features as other tumors, a diagnosis may be difficult. MRI and CT scanning are used to view swelling around the tumor. Ultrasound is also helpful in locating the tumor.
Spinal angiography is used for large tumors when the diagnosis can’t be made by MRI alone. Angiography shows the definition of the tumor, including the feeding and draining blood vessels. This information is particularly helpful during surgery to remove the tumor.
Symptoms vary depending on the location of the hemangioblastoma, but may include:
At UPMC we treat hemangioblastomas by resection (surgery to remove the tumor) or radiosurgery. If a hemangioblastoma can be completely removed and is not associated with von Hippel Lindau disease, the patient can be cured. If the entire tumor cannot be resected, it is likely that the tumor will re-grow or that additional cysts will form. However, most hemangioblastomas can be safely removed.
Stereotactic radiosurgery is an alternative to open surgery that is noninvasive and doesn’t carry the risks of conventional brain or spine surgery. It is particularly useful in treating hemangioblastomas that are located in areas of the brain that are difficult to access safely with conventional surgery. In a single radiosurgery session, the tumor is targeted and will take from six months to a year to be destroyed. Radiosurgery is an outpatient procedure, so the patient does not need to recover before resuming normal activities.
Spine Radiosurgery: An Alternative Approach
Dr. Peter Gerszten discusses the advantages to spine radiosurgery treatment for patients.