title: [Epidemiology, treatment and follow-up of central nervous system hemangioblastomas in von Hippel-Lindau disease].
abstract: BACKGROUND
  Central nervous system (CNS) hemangioblastomas (HGB) are rare vascular tumors. The goal of this study was to analyze their epidemiology, treatment and prognosis in association with von Hippel-Lindau (VHL) disease.
  
  
  METHODS
  We retrospectively reviewed a series of patients treated in our department for a CNS HGB with VHL disease between 1996 and 2008. We analyzed pre- and postoperative clinical and radiological characteristics, number of visceral lesions (fundoscopy, abdomino-pelvian CT, metanephrines), clinical course (modified Rankin Scale and McCormick scale) and late prognosis (Kaplan-Meier survival curves).
  
  
  RESULTS
  We studied 19 cases (sex-ratio 0.9, mean age 36). The mean time to diagnosis was 61days. The main symptom was intracranial hypertension for cerebellar lesions (7/15) and a sensitive-motor deficit for medulla oblongata (2/5) or spinal lesions (5/11). Preferred locations were cerebellum (15/31), often nodulo-cystic appearance, followed by spinal cord (11/31), frequently coming with adjacent syringomyelia. Multiple locations and visceral lesions were found in two-third of the cases. Surgical removal was complete in more than three-quarter of the cases. Mean follow-up duration was 9years. Postoperative mortality rate was 16%. In cerebellar and medulla oblongata locations together, final mRS was ≤1 in 17 of the 20 cases. In spinal cord locations, final McCormick score was ≤2 in all the cases. After delayed follow-up, about two-third of patients experienced recurrence or new progressive CNS lesions.
  
  
  CONCLUSIONS
  HGB are rare CNS tumors. VHL disease should be considered when an HGB is diagnosed before 30, is located at the spinal cord, comes with multiple other CNS lesions or with typical peripheral lesions. Microsurgical removal is the gold standard treatment and can offer good functional results.
authors.affiliation: Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Sankaredja
authors.affiliation: Faculté de médecine de Lille, université Lille 2 (Option Initiation à la Rédaction d'Article), 1, place de Verdun, 59000 Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Brac
authors.affiliation: Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France; Faculté de médecine de Lille, université Lille 2 (Option Initiation à la Rédaction d'Article), 1, place de Verdun, 59000 Lille, France. Electronic address: laurent.thines@wanadoo.fr.
authors.forename: L
authors.initials: L
authors.lastname: Thines
authors.affiliation: Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Baroncini
authors.affiliation: Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Zairi
authors.affiliation: Service de médecine interne et d'endocrinologie, hôpital Huriez, CHRU de Lille, université Lille Nord-de-France, 1, place de Verdun, 59000 Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Cardot-Bauters
authors.affiliation: Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lejeune
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D002531:Cerebellum / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018325:Hemangioblastoma / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology; D016019:Survival Analysis; D055815:Young Adult; D006623:von Hippel-Lindau Disease / Q000150:complications* / Q000453:epidemiology / Q000628:therapy
keywords: Follow-up; Hemangioblastoma; Hémangioblastome; Maladie de von Hippel-Lindau; Neurochirurgie; Neurosurgery; Prognosis; Pronostic; Suivi; Von Hippel-Lindau disease