Abstract
Objective: We report two cases of large cerebellar solid hemangioblastomas treated by preoperative embolization using n-butyl cyanoacrylate (NBCA).
Case presentation: A 22-year-old woman and a 22-year-old man presented with headache and unsteadiness. Magnetic resonance imaging revealed a large cerebellar solid mass, size 2.5 cm and 3.7 cm, respectively. The tumors were fed by multiple feeders from a posterior inferior cerebellar artery. To reduce intraoperative bleeding, preoperative embolizations were performed using NBCA. Flow-guided microcatheters were navigated into the feeding arteries, if possible. Diluted NBCA was slowly injected to avoid reflux and extravasation. Complete devascularization was achieved after glue embolization without any complication in both cases. Tumors were totally resected with minimal blood loss several days after the embolization.
Conclusion: NBCA penetrates deep into the feeding arteries and devascularizes the hemangioblastoma. Preoperative embolization using NBCA is safe and efficacious for large cerebellar solid hemangioblastomas.
