title: The clinical experience of recurrent central nervous system hemangioblastomas.
abstract: OBJECTIVE
  Hemangioblastomas (HBLs) of the central nervous system are benign vascular tumors that may occur sporadically or in von Hippel-Lindau disease (VHLD). We analyzed the clinical and radiological findings of HBLs focusing on recurrence.
  
  
  METHODS
  From 1998 to 2012, 36 patients with HBLs were treated. Twenty nine patients (80.6%, mean age 46.7 years) had sporadic HBLs and seven (19.4%, mean age 39 years) had HBLs associated with VHLD. Initially, the mass was totally removed in 32 patients, subtotally in one and partially in one, and gamma knife radiosurgery was done in two patients. The mean duration of follow-up was 48.4 months. We retrospectively analyzed the clinical and radiologic findings.
  
  
  RESULTS
  The location of cerebellum and brainstem was common. The HBLs of spinal cord and cerebral hemisphere were related with VHLD. The common radiologic findings of sporadic HBLs showed a cyst with a mural nodule in 15 patients (51.7%) and pure solid lesion in eight (27.6%). In HBLs related with VHLD, five of seven patients had multiple lesions and pure solid mass was common. Three (10.3%) and two (28.6%) patients showed recurrence in sporadic and VHLD-related HBLs, respectively. Two totally resected mural nodules on the cyst showed recurrence with similar radiologic findings 3 years later in sporadic HBLs. In recurred HBLs related with VHLD, one pure solid mass and one mural nodule on cyst showed the local recurrences after the total resection 8 years later and associated with distant recurrence.
  
  
  CONCLUSIONS
  All patients should be more specifically followed to detect local and distant recurrence, even if the clinical course was benign and mass was totally removed.
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Gwang-Jun
authors.initials: GJ
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea. Electronic address: jung-ty@chonnam.ac.kr.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: In-Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Woo-Youl
authors.initials: WY
authors.lastname: Jang
authors.affiliation: Department of Neurosurgery, Brain Tumor Clinic Gamma Knife Center, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Kyung-Sub
authors.initials: KS
authors.lastname: Moon
authors.affiliation: Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, South Korea.
authors.forename: Seul-Kee
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D020295:Brain Stem Neoplasms / Q000473:pathology; D002528:Cerebellar Neoplasms / Q000473:pathology* / Q000601:surgery; D003560:Cysts; D005260:Female; D005500:Follow-Up Studies; D018325:Hemangioblastoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology
keywords: Clinical; Hemangioblastoma; Radiology; Recurrence; von Hippel–Lindau disease