title: Neuropathological characteristics of progression after prolonged response to bevacizumab in multifocal hemangioblastoma.
abstract: BACKGROUND
  Antiangiogenic treatment has been explored in few patients with hemangioblastoma after failure of surgery and radiotherapy.
  
  
  METHODS
  We present the first histopathological follow-up study of a bevacizumab-responsive hemangioblastoma that eventually progressed. For a period of 12 months, therapy with bevacizumab achieved a clinical response and radiological stabilization in a patient with progressive multifocal central nervous system (CNS) hemangioblastoma. Subsequently, selected tumor sites showed radiological progression, in particular, the formation of an intramedullary lesion of the initially predominantly leptomeningeal disease. Histology showed diffuse dural invasion by the hemangioblastoma accompanied with a relatively reduced cell density compared to the preserved vessel structures.
  
  
  CONCLUSIONS
  The pattern of progression upon vascular endothelial growth factor (VEGF)-targeting antiangiogenic treatment in hemangioblastoma may involve increased tumor invasiveness.
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Seystahl
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.forename: Oliver
authors.initials: O
authors.lastname: Bozinov
authors.forename: Regina
authors.initials: R
authors.lastname: Reimann
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rushing
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D018325:Hemangioblastoma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D013120:Spinal Cord Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab