Clinical characteristics and outcomes of cerebellar hemangioblastoma patients of surgical resection: A retrospective study

Objectives: Cerebellar hemangioblastomas are rare, slow-growing central nervous system tumors that usually occur in the cerebellum, brainstem, and spinal cord. The present study aimed to examine the clinical features of patients diagnosed with cerebellar hemangioblastoma and evaluate surgical resection outcomes. Materials and Methods: This retrospective analysis involved 113 patients with sporadic cerebellar hemangioblastomas who underwent tumor removal surgery between January 2020 and December 2024. Tumors were categorized as solid, mixed solid-cystic, or primarily cystic. A midline or lateral suboccipital craniectomy was performed according to tumor location, and surgical and imaging data were combined to assess recurrence or progression. Neurological evaluations were conducted before surgery, immediately after, and at routine follow-ups. Outcomes were compared and analyzed. Results: The study included 113 patients (mean age 41.6 ± 9.78 years; 69 males and 44 females). Common symptoms were vertigo, headache, and ataxia, while diplopia and blurred vision were less frequent. The mean symptom duration before diagnosis was 4.2 ± 3.7 months. Magnetic resonance imaging revealed obstructive hydrocephalus in 36.29% of patients, left cerebellar hemisphere involvement in 28.32%, right hemisphere in 24.78%, and vermis location in 7.96%. Tumors were cystic (55.75%), solid (39.83%), or mixed (4.42%). Poor outcomes were significantly associated with older age (61.76 ± 14.67 years vs. 45.91 ± 13.98 years, p < 0.0001), anterior tumor location ( p < 0.0001), and solid composition ( p = 0.0003). Pre-operative tumor size did not affect outcomes ( p = 0.57). The mean overall survival was 31.27 months, with the improved group showing significantly longer survival (45.32 months, 95% confidence interval [CI]: 42.1–48.5) compared to the no-improved group (9.10 months, 95% CI: 7.4–10.8; p < 0.0001). Conclusion: Older age, anterior tumor location, and solid tumor type were associated with poor outcomes in cerebellar hemangioblastoma. Pre-operative tumor size was not predictive of prognosis. Complete resection provides favorable long-term survival, particularly for cystic and posteriorly located lesions.