title: Surgical treatment for hemangioblastomas in the medulla oblongata.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the outcome of surgical treatment of hemangioblastomas in the medulla oblongata.
  
  
  METHODS
  Between January 2006 and December 2007, 18 patients who underwent surgery for hemangioblastomas in the medulla oblongata in the Neurosurgical Department of Huashan Hospital were retrospectively reviewed.
  
  
  RESULTS
  The study population was 13 males and five females. The main symptoms were headache, cervical pain, and dizziness. All patients had preoperative and postoperative examination by MRI. There were five cystic tumors and 13 solid tumors. Tumor diameter ranged from 1 to 4.3 cm (mean, 2.6 cm). Complete tumor resection was achieved in all patients, but one patient died. Embolization was done in three patients. According to McCormick scale, postoperative condition was worse in one patient, unchanged in 14 patients, and improved in three patients. In follow-up assessments, no surviving patients remained in a worse condition. Compared with the preoperative condition, 11 patients were unchanged, and six patients exhibited improvement. Tumor recurrence was not observed during follow-up.
  
  
  CONCLUSIONS
  Surgery is the first-line treatment for symptomatic patients with hemangioblastomas in the medulla oblongata. Good results can be achieved for the cystic or small solid tumors. Large solid tumors remain a surgical challenge due to arteriovenous malformation-like vascularization. Preoperative embolization is useful for large solid tumors. For asymptomatic tumors, careful long-term observation or radiosurgery could be chosen.
authors.affiliation: Department of Neurosurgery, Huashan Hospital of Fudan University, Shanghai, China.
authors.forename: Qi Wu
authors.initials: QW
authors.lastname: Xu
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.forename: Zhuo Ying
authors.initials: ZY
authors.lastname: Du
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020295:Brain Stem Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D018325:Hemangioblastoma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult