Bevacizumab for the treatment of surgically unresectable cervical cord hemangioblastoma: a case report

IntroductionHemangioblastomas are highly vascular tumors that can arise within the central nervoussystem as well as other organ systems within the body. They can arise sporadically or as partof Von Hippel Lindau syndrome.

Those arising in critical locations within the central nervoussystem can be difficult to resect surgically and therefore pose a significant challenge andresult in morbidity and even mortality. Hemangioblastomas express high levels of vascularendothelial growth factor that drives angiogenesis and tumor progression.

We hypothesizedthat bevacizumab through its inhibitory effect on vascular endothelial growth factor willresult in hemangioblastoma tumor regression as well as a meaningful clinical response.Case presentationWe present the case of a 51-year-old Caucasian man with surgically unresectable cervicalcord hemangioblastoma presenting with progressive weakness leading to quadriparesis. Hewas treated with bevacizumab and his follow up magnetic resonance imaging scans showedmarked tumor regression.

After only six cycles of intravenous bevacizumab (10mg/kg everytwo weeks), he started ambulating after being wheelchair bound. He is currently stillreceiving treatment almost two years after initiation of bevacizumab.

Conclusions: We have shown for the first time that bevacizumab can result in significant tumor regressionand a sustained clinical improvement in a patient with an otherwise unresectable spinal cordhemangioblastoma.

This novel approach can be immensely useful for patients with difficultto resect hemangioblastomas or those with multiple lesions such as in Von Hippel Lindausyndrome.

Author: Ayman I Omar
Credits/Source: Journal of Medical Case Reports 2012, 6:238

Published on: 2012-08-10

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