Stereotactic Radiosurgery for Cerebellar Hemangioblastoma in von Hippel–Lindau Disease

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We report a case of a 47-year-old female with von Hippel–Lindau disease with multiple intracranial hemangioblastomas. She presented with left-sided weakness and dizziness. A computed tomography (CT) scan of the brain revealed a lesion within the posterior fossa. She was treated initially in 1993 with surgical resection. Three years later, she experienced recurrence of her symptoms, and re-excision of two additional lesions was performed. Follow-up magnetic resonance imaging (MRI) revealed multiple hemangioblastomas not amenable to further resection. Because of continued symptoms, she was treated with stereotactic radiosurgery using three non-coplanar arcs via a 20 mm collimator to a dose of 16 Gy prescribed to the 90% isodose volume. Over the several months following radiosurgery, she had resolution of neurologic symptoms. We review the literature on radiation therapy for hemangioblastomas with particular attention to stereotactic radio-surgery. The reported experience suggests stereotactic radiosurgery has an important role in the management of hemangioblastomas.

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