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Hemangioblastoma

Hemangioblastomas are benign tumors that arise from the lining of blood vessels. Hemangioblastomas can occur in the brain, spinal cord, and retina (back of the eye).

Spinal hemangioblastomas are usually found on the surface of the spinal cord. They constitute 5-10% of intramedullary tumors or tumors arising in the spinal cord.

Hemangioblastomas are a type of hemangioma or blood vessel tumors.


Symptoms


Small hemangioblastomas that do not cause any symptoms due to their slow-growing and benign nature may not need treatment. These are usually found incidentally (in transit) and can simply be followed up with annual imaging scans.

Larger hemangioblastomas can cause a variety of symptoms as they compress the spinal cord. Symptoms may include: numbness or tingling in the arms or legs, clumsiness in the hands, weakness in the arms or legs, difficulty walking and/or impaired bowel and bladder function. The exact symptoms depend on the size and location of the tumor.


Diagnosis


Hemangioblastomas are diagnosed with MRI (magnetic resonance) scans and/or CT (computed tomography, also known as CAT scans). MRI scans use magnets, radio waves, and computer technology to produce images of organs and tissues such as the brain and spinal cord. CT scans use a combination of X-rays and computer technology to produce detailed images of bones and soft tissues.

Both scans can be done after injection of a contrast enhancing agent that enhances the visualization of the lesion on scans.

Spinal angiography or examination of blood flow around the tumor may also be done as part of surgical planning. This study is particularly useful for hemangiomas; As tumors of blood vessels, they have strong blood supplies.


Risk factors


Hemangioblastomas arise from primitive blood vessel cells. They occur most often in the early and middle years of life and affect men and women equally.

In most cases, patients have a single hemangioblastoma. These are called sporadic cases. However, patients with the inherited genetic condition von Hippel-Lindau Disease are predisposed to develop multiple hemangioblastomas as well as cysts throughout the body, including the kidneys and other organs.


Treatments


The preferred treatment for symptomatic spinal cord hemangioblastomas is removal using a microsurgical or surgical microscope and very fine surgical instruments. Most tumors can be completely removed using standard microsurgical techniques and neurological function can usually be preserved.

Radiation therapy may be beneficial if the entire tumor cannot be safely removed in surgery.


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