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Laviv Y, Saraf D, Oxman L, Zvi IB. Supratentorial hemangioblastoma: correlation between phenotype, gender and vascular territory affected. Neurosurg Rev 2023; 46:281. [PMID: 37875641 DOI: 10.1007/s10143-023-02194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/17/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Abstract
Supratentorial hemangioblastomas are rare, vascular lesions. The presence of peri-tumoral cysts and edema has meaningful clinical, diagnostic and therapeutic implications. Nevertheless, the pathogenesis of both cyst and edema formation is not fully understood. This study sought to determine if the radiologic phenotype of supratentorial hemangioblastoma is affected by the different cerebral arterial circulations. Review of the English-language literature from 1973 to 2023 yielded 53 cases of parenchymal supratentorial hemangioblastomas eligible for analysis. Patients were divided by the vascular territorial distribution of the lesions: anterior circulation (n = 36) or posterior circulation (n = 17), and the groups were compared for demographic, clinical, radiologic and molecular variables. Univariate analyses yielded a significant difference between the groups in five variables. Cystic changes and "classic" radiological phenotype were associated with hemangioblastomas of the posterior circulation (OR = 0.19, p = 0.045 and OR = 0.287, p = 0.048, respectively), while female gender, significant peritumoral edema and purely solid phenotype were associated with hemangioblastomas of the anterior circulation (OR = 3.384, p = 0.045 and OR = 5.25, p = 0.05 and OR = 14.0, p = 0.015; respectively). On multivariate analysis, solid phenotype and female gender remained significantly associated with the anterior circulation (OR = 36.04, p = 0.014 and OR = 4.45, p = 0.045). The incidence of von-Hippel Lindau disease was higher in the anterior-circulation group. Cystic tumors were present in all females in the posterior-circulation group compared to 43.4% in the anterior-circulation group (OR = 20.714, 95% CI 1.061 to 404.122; p = 0.045). Based on historical cases of supratentorial hemangioblastoma, this study shows that different tumor phenotypes are associated with the different cerebral circulations. Gender was also associated with differences in tumor distribution and radiologic phenotype. These novel data may improve our understanding of unique vascular diseases of the central nervous system.
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Affiliation(s)
- Yosef Laviv
- Department of Neurosurgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - David Saraf
- Department of Neurosurgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Oxman
- Department of Neurosurgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Ben Zvi
- Department of Neurosurgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Jankovic D, Vuong K, Splavski B, Rotim K, Arnautovic KI. Supratentorial Hemangioblastoma in Adults: A Systematic Review and Comparison of Infratentorial and Spinal Cord Locations. World Neurosurg 2023; 173:48-62. [PMID: 36822402 DOI: 10.1016/j.wneu.2023.02.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Supratentorial hemangioblastomas are benign and highly vascularized neoplasms that appear most often in the spine and posterior cranial fossa. They can also be located in the supratentorial compartment of the brain. We conducted a systematic review of the literature to better understand the clinical insights of supratentorial hemangioblastoma in adults. METHODS Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the authors reviewed the English-language literature in the PubMed/MEDLINE database on supratentorial hemangioblastoma in adults, published in the past 40 years. We analyzed the differences between sporadic hemangioblastomas and hemangioblastomas associated with von Hippel-Lindau disease. In addition, we compared the characteristics of supratentorial hemangioblastomas with infratentorial and spinal cord locations. RESULTS We reviewed 92 articles, describing 157 supratentorial hemangioblastomas in a total cohort of 148 adult patients. Most articles reporting supratentorial hemangioblastomas were published in the United States. Supratentorial hemangioblastomas occur more frequently in women than men. The median age at the time of diagnosis was 44.48 years. The sellar/parasellar region was the most commonly tumor location, while the most common morphological type was the solid type. Almost 80% of hemangioblastomas were completely resected; the outcome was favorable in more than 3 fourth of patients. CONCLUSIONS Given their rarity, the literature on supratentorial hemangioblastomas is limited and based mostly on case reports. Complete surgical resection is the first choice of treatment and is associated with a good treatment outcome.
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Affiliation(s)
- Dragan Jankovic
- Department of Neurosurgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany; Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Kyna Vuong
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Bruno Splavski
- Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia
| | - Kresimir Rotim
- Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Faculty of Medicine, University of Zagreb, Zagreb, Croatia
| | - Kenan I Arnautovic
- Semmes Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
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Yoda RA, Cimino PJ. Neuropathologic features of central nervous system hemangioblastoma. J Pathol Transl Med 2022; 56:115-125. [PMID: 35501672 PMCID: PMC9119802 DOI: 10.4132/jptm.2022.04.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Hemangioblastoma is a benign, highly vascularized neoplasm of the central nervous system (CNS). This tumor is associated with loss of function of the VHL gene and demonstrates frequent occurrence in von Hippel-Lindau (VHL) disease. While this entity is designated CNS World Health Organization grade 1, due to its predilection for the cerebellum, brainstem, and spinal cord, it is still an important cause of morbidity and mortality in affected patients. Recognition and accurate diagnosis of hemangioblastoma is essential for the practice of surgical neuropathology. Other CNS neoplasms, including several tumors associated with VHL disease, may present as histologic mimics, making diagnosis challenging. We outline key clinical and radiologic features, pathophysiology, treatment modalities, and prognostic information for hemangioblastoma, and provide a thorough review of the gross, microscopic, immunophenotypic, and molecular features used to guide diagnosis.
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Affiliation(s)
- Rebecca A. Yoda
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, Division of Cytopathology, University of Washington, Seattle, WA, USA
- Corresponding Author: Rebecca A. Yoda, MD, Department of Laboratory Medicine and Pathology, University of Washington, 325 9th Avenue, Box 359791, Seattle, WA 98104-2499, USA Tel: +1-206-744-3145, Fax: +1-206-744-8240, E-mail:
| | - Patrick J. Cimino
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA
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The loss of succinate dehydrogenase B expression is frequently identified in hemangioblastoma of the central nervous system. Sci Rep 2019; 9:5873. [PMID: 30971719 PMCID: PMC6458311 DOI: 10.1038/s41598-019-42338-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/27/2019] [Indexed: 12/23/2022] Open
Abstract
Succinate dehydrogenase (SDH) is a mitochondrial enzyme that plays an important role in both the Krebs cycle and the electron transport chain. SDH inactivation is associated with tumorigenesis in certain types of tumor. SDH consists of subunits A, B, C and D (SDHA, SDHB, SDHC, and SDHD, respectively). Immunohistochemistry for SDHB is a reliable method for detecting the inactivation of SDH by mutations in SDHA, SDHB, SDHC, SDHD and SDH complex assembly factor 2 (SDHAF2) genes with high sensitivity and specificity. SDHB immunohistochemistry has been used to examine the inactivation of SDH in various types of tumors. However, data on central nervous system (CNS) tumors are very limited. In the present study, we investigated the loss of SDHB immunoexpression in 90 cases of CNS tumors. Among the 90 cases of CNS tumors, only three cases of hemangioblastoma showed loss of SDHB immunoexpression. We further investigated SDHB immunoexpression in 35 cases of hemangioblastoma and found that 28 (80%) showed either negative or weak-diffuse pattern of SDHB immunoexpression, which suggests the inactivation of SDH. Our results suggest that SDH inactivation may represent an alternative pathway in the tumorigenesis of hemangioblastoma.
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Rocha L, Noronha C, Taipa R, Reis J, Gomes M, Carvalho E. Supratentorial hemangioblastomas in von Hippel–Lindau wild-type patients – case series and literature review. Int J Neurosci 2017; 128:295-303. [DOI: 10.1080/00207454.2017.1385613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Luís Rocha
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
| | - Carolina Noronha
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
| | - Ricardo Taipa
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
| | - Joaquim Reis
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
| | - Mário Gomes
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
| | - Ernesto Carvalho
- Serviço de Neurocirurgia, Centro Hospitalar do Porto, Porto, Portugal
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