Hemangioblastoma (HB) is a rare, highly vascularized, and benign central nervous system (CNS)
tumor. This vascularity is due to a high degree of signaling by
vascular endothelial growth factor (
VEGF). Consequently, anti-
VEGF agents, such as
bevacizumab, have been postulated and shown in a few cases to be effective in treating these
tumors when surgical
therapy is not feasible. Additionally, selective intra-arterial (IA) administration of
bevacizumab has shown promise in treating other
cancers such as
glioblastoma (GBM). Here, we present the case of a 60-year-old female with a symptomatic posterior fossa HB where embolization and surgery were not feasible due to
tumor location. She underwent selective IA treatment with
bevacizumab, which led to
tumor stability and symptomatic improvement.
Bevacizumab has been used intravenously (IV) as a treatment for HB, however, its efficacy has not been well-established. This case demonstrates the potential viability of selective bevacizumab in
HB, as demonstrated by symptomatic improvement and decreased
tumor size on MRI. Further research is needed to demonstrate the specific efficacy of IA
bevacizumab for CNS HB when surgery or other treatment modalities are not viable options.