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Surgical resection of medulla oblongata hemangioblastomas: outcome and complications

  • Clinical Article - Brain Tumors
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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.

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Authors and Affiliations

  1. Department of Neurosurgery, BicĂŞtre University Hospital, Le Kremlin-BicĂŞtre, France

    Lorenzo Giammattei, Mahmoud Messerer, Nozar Aghakhani, Philippe David, Anne Herbrecht & Fabrice Parker

  2. Department of Neurosurgery, Fondazione IRCCS “Istituto Neurologico C. Besta”, Via. G. Celoria 11, Milan, 20133, Italy

    Lorenzo Giammattei

  3. Département de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland

    Mahmoud Messerer

  4. Laboratoire de Génétique Oncologique EPHE, CHU de Bicêtre, Le Kremlin-Bicêtre, France

    Stéphane Richard

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  1. Lorenzo Giammattei
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  4. Philippe David
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  6. Stéphane Richard
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Correspondence to Lorenzo Giammattei.

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No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Giammattei, L., Messerer, M., Aghakhani, N. et al. Surgical resection of medulla oblongata hemangioblastomas: outcome and complications. Acta Neurochir 158, 1333–1341 (2016). https://doi.org/10.1007/s00701-016-2834-0

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  • DOI: https://doi.org/10.1007/s00701-016-2834-0

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