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Growth rate and fate of untreated hemangioblastomas: clinical assessment of the experience of a single institution

  • Joonho Byun
  • Hee Jun Yoo
  • Jeong Hoon KimEmail author
  • Young Hoon Kim
  • Young Hyun Cho
  • Seok Ho Hong
  • Chang Jin Kim
Clinical Study

Abstract

Background

The growth rate and natural history of untreated hemangioblastomas remain unclear. This study investigated the natural history of untreated intracranial hemangioblastomas and predictors of tumor growth using volumetric assessment.

Method

This study retrospectively enrolled 31 patients with untreated hemangioblastomas between 2004 and 2017 who were followed up for at least 12 months. The 31 patients had a total of 52 hemangioblastomas.

Results

The 31 patients included 11 (35.5%) men and 20 (64.5%) women, of mean age 42.5 years. Seventeen (54.8%) patients were genetically diagnosed with Von Hippel-Lindau (VHL) disease. Of the 52 lesions, 33 (63.5%) grew during the follow-up period, whereas 19 (36.5%) remained stable. Overall mean actual growth rate (AGR) was 1.94 cm3/year, 2.38 cm3/year in the VHL and 1.79 cm3/year in the non-VHL group (p = 0.31). Overall mean relative growth rate (RGR) was 21%/year, 26%/year in the VHL and 19%/year in the non-VHL group. Time to 50% treatment probability was 34 months. The 1, 3, 5, and 7-year treatment probabilities were 11.5%, 50.1%, 52.7%, and 73%, respectively. The presence of only symptomatic lesions was significantly predictive of the growth of intracranial hemangioblastoma (odds ratio: 5.0, p = 0.02).

Conclusion

The overall growth rate of intracranial hemangioblastoma was faster than that of other benign intracranial tumors, with symptomatic lesions being the only meaningful predictor of tumor growth. Because of their rapid growth rate and high probability of treatment, a wait and scan management strategy should be carefully applied to intracranial hemangioblastomas.

Keywords

Intracranial hemangioblastoma Growth rate Predictor Treatment 

Notes

Acknowledgements

The authors thank the referring physicians and the neuroradiologists and pathologists of our institution. We also thank Na Young Kim, a statistician in our institute, who performed the statistical analysis and assisted in the writing of the Methods section of this report.

Compliance with ethical standards

Conflicts of interest

The authors declare no competing interests in relation to this study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurological Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea

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