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ISSN 0028-3851 (Print)

2005, Number 3

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Rev Neurol Neurocir Psiquiat 2005; 38 (3)

Stereotaxic surgery in craniopharyngeomas, 13 years of experience

Salva CS, Avila EM, Martínez SJE, Camblor SJL

Language: Spanish
References: 52
Page: 87-92
PDF size: 66.30 Kb.


ABSTRACT

Introduction. Intracraneal tumors continue being an important challenge for the clinical investigators. They are grouped in injuries with a primary growth, derived from the CNS, secondary or metastatic. Craniopharyngiomas are cystic tumors, solid or mixed with or without calcifications, and they are originated of craniopharyngeal duct’s remnants and/or Rathke’s pouch fissure. Embryogenetics and metaplastic interrelate craniopharyngiomas origin with small embryonic. This tumor constitutes 2,5-4% of all the intracranial tumors. In children they represent 5-10% of all tumors or 56% of all the tumors of the sellar and suprasellar region. Although all ages can be affected, its distribution is 5-10 years and lower between 50-60 years.
Material and methods: 21 patients were studied with craniopharyngiomas diagnosis operated by means of stereoataxic in the Service of Neurosurgery of the Surgical Clinical Hospital Ameijeiras Brothers, of the city of Havana, from 1990 to 2003.
Results. Adults over 16 years predominated with 57%. The age rank of the series oscillated between the three and 60 years, with an average of 31 years. Ameloblastomatous craniopharyngiomas predominance in the total of the cases studied in our series was 100%: in 19 cases (90.5) the cyst type was frequently found, in two cases (9.5) the tumor was mixed. Papilar squamous subtype was not demonstrated in any case.
Conclusion. Craniopharyngiomas appeared with more frequency in young patients of masculine sex, 100% of the cases were ameloblastomatous injuries. Stereoataxic ACT allowed to determine the cyst volume in all cases and constituted the election study for the evolutionary follow-up.


REFERENCES

  1. López G. Resección microquirúrgica estereotáxica de tumores intracraneales guiados por imagen y asistidos por computadora. La Habana. CIREN 1998 (Tesis de grado).

  2. Salva S. Cirugía estereotáxica en lesiones expansivas intracraneales. Hospital Hermanos Ameijeiras 1994 (Tesis de grado).

  3. López OL. Cirugía estereotáxica en tumores de tallo cerebral. Hospital Hermanos Ameijeiras 1997 (Tesis de grado).

  4. Law ER Jr., Kaye AH. Brain tumors, an encyclopedic approach. Second edition. 2003: 46: 945-6.

  5. Bunin GR, Surawicz TS, Witman PA. The descriptive epidemiol-ogy of craniopharyngioma. J Neurosurg 1998; 89(4): 547-51.

  6. Pollack IF. Current concepts: Brain tumors in children. N Engl J Med 1994; 331: 1500-7.

  7. Weiner HL, Wisoff JH, Rosenberg ME. Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 1994; 35(6): 1001-10; discussion 1010-1

  8. Adamson TE, Wiestler OW, Kleihues P, Yasargil MG. Correlation of clinical and pathological features in surgically treated craniopharyngiomas J Neurosurgery 1990; 73: 12-7.

  9. Anderson CA, Wilkening GN, Filley CM, et al. Neurobehavioral outcome in pediatric craniopharyngioma. Pediatr Neurosurg 1997; 26: 255–60.

  10. Fisher PG, Jenab J, Goldthwaite PT, et al. Outcomes and failure patterns in childhood craniopharyngiomas. Childs Nerv Syst 1998; 14: 558-63.

  11. Gildenberg PL. The birth of stereotactic surgery: a personal retrospective. Neurosurgery 2004; 54: 198-208.

  12. Backlund EO. Treatment of craniopharyngiomas: The multimodality approach. Pediatr Neurosurg 1994; 21[Suppl. 1]: 82-9.

  13. Nicolato A, Foroni R, Rosta L, Gerosa M, Bricolo A. Multimodality stereotactic approach to the treatment of cystic craniopharyngiomas. Minim Invasi Neurosurg 2004 Feb; 47(1): 32-40.

  14. Habrand JL, Ganry O, Couanet D, et al. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 1999; 44: 255-63.

  15. Gonc EN, Yordam N, Ozon A, Alikasifoglu A, Kandemir N. Endocrinological outcome of different treatment options in children with craniopharyngioma: a retrospective analysis of 66 cases. Pediatr Neurosurg 2004; 40(3): 112-9.

  16. Inenaga C, Kakita A, Iwasaki Y, Yamatani K, Takahashi H. Autopsy findings of a craniopharyngioma with a natural course over 60 years. Surg Neurol 2004; 61(6): 536-40; discussion 540.

  17. Ben Amor A, Ach K, Harzallah L, Zaouali M, Maaroufi A, Chaieb Chadli M, Chaieb L. Craniopharyngioma of the adults. Three cases. Ann Endocrinol (Paris) 2003; 64(6): 428-33.

  18. Donnet A, Schmitt A, Dufour H, et al. Neuropsychological follow-up of twenty two adult patients after surgery for craniopharyngioma. Acta Neurochir 1999; 141: 1049-54.

  19. Duff JM, Meyer FB, Ilstrup DM, et al. Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 2000; 46: 291-305.

  20. Honegger J, Buchfelder M, Fahlbusch R. Surgical treatment of craniopharyngiomas: endocrinological results. J Neurosurg 1999; 90: 251-7.

  21. Hasegawa T, Kondziolka D, Hadjipanayis CG, Lunsford LD. Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery 2004; 54(4): 813-20; discussion 820-2.

  22. Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: A study of 122 surgical cases. J Neurosurg 2002; 97: 3-11.

  23. Fahlbusch R, Honegger J, Paulus W, et al. Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 1999; 90: 237-50.

  24. Abe T, Ludecke DK. Transnasal surgery for infradiaphragmatic craniopharyngiomas in pediatric patients. Neurosurgery 1999; 44: 957-66.

  25. Wang K-C, Kim S-K, Choe G, Chi JG, Cho B-K. Growth patterns of craniopharyngioma in children: Role of the diaphragm sellae and its surgical implication. Surg Neurol 2002; 57: 25-33.

  26. Shirane R, Su CC, Kusaka Y, Jokura H, Yoshimoto T. Surgical outcome in 31 patients with craniopharyngiomas extending outside the suprasellar cistern: An evaluation of the frontobasal interhemispheric approach. J Neurosurg 2002; 96: 704-12.

  27. López G. Resección microquirúrgica estereotáxica de tumores intracraneales guiados por imagen y asistidos por computadora. La Habana. CIREN 1998 (Tesis de grado).

  28. Salva S. Cirugía estereotáxica en lesiones expansivas intracraneales. Hospital Hermanos Ameijeiras 1994 (Tesis de grado).

  29. López OL. Cirugía estereotáxica en tumores de tallo cerebral. Hospital Hermanos Ameijeiras 1997 (Tesis de grado).

  30. Law ER Jr., Kaye AH. Brain tumors, an encyclopedic approach. Second edition. 2003: 46: 945-6.

  31. Bunin GR, Surawicz TS, Witman PA. The descriptive epidemiol-ogy of craniopharyngioma. J Neurosurg 1998; 89(4): 547-51.

  32. Pollack IF. Current concepts: Brain tumors in children. N Engl J Med 1994; 331: 1500-7.

  33. Weiner HL, Wisoff JH, Rosenberg ME. Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 1994; 35(6): 1001-10; discussion 1010-1

  34. Adamson TE, Wiestler OW, Kleihues P, Yasargil MG. Correlation of clinical and pathological features in surgically treated craniopharyngiomas J Neurosurgery 1990; 73: 12-7.

  35. Anderson CA, Wilkening GN, Filley CM, et al. Neurobehavioral outcome in pediatric craniopharyngioma. Pediatr Neurosurg 1997; 26: 255–60.

  36. Fisher PG, Jenab J, Goldthwaite PT, et al. Outcomes and failure patterns in childhood craniopharyngiomas. Childs Nerv Syst 1998; 14: 558-63.

  37. Gildenberg PL. The birth of stereotactic surgery: a personal retrospective. Neurosurgery 2004; 54: 198-208.

  38. Backlund EO. Treatment of craniopharyngiomas: The multimodality approach. Pediatr Neurosurg 1994; 21[Suppl. 1]: 82-9.

  39. Nicolato A, Foroni R, Rosta L, Gerosa M, Bricolo A. Multimodality stereotactic approach to the treatment of cystic craniopharyngiomas. Minim Invasi Neurosurg 2004 Feb; 47(1): 32-40.

  40. Habrand JL, Ganry O, Couanet D, et al. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 1999; 44: 255-63.

  41. Gonc EN, Yordam N, Ozon A, Alikasifoglu A, Kandemir N. Endocrinological outcome of different treatment options in children with craniopharyngioma: a retrospective analysis of 66 cases. Pediatr Neurosurg 2004; 40(3): 112-9.

  42. Inenaga C, Kakita A, Iwasaki Y, Yamatani K, Takahashi H. Autopsy findings of a craniopharyngioma with a natural course over 60 years. Surg Neurol 2004; 61(6): 536-40; discussion 540.

  43. Ben Amor A, Ach K, Harzallah L, Zaouali M, Maaroufi A, Chaieb Chadli M, Chaieb L. Craniopharyngioma of the adults. Three cases. Ann Endocrinol (Paris) 2003; 64(6): 428-33.

  44. Donnet A, Schmitt A, Dufour H, et al. Neuropsychological follow-up of twenty two adult patients after surgery for craniopharyngioma. Acta Neurochir 1999; 141: 1049-54.

  45. Duff JM, Meyer FB, Ilstrup DM, et al. Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 2000; 46: 291-305.

  46. Honegger J, Buchfelder M, Fahlbusch R. Surgical treatment of craniopharyngiomas: endocrinological results. J Neurosurg 1999; 90: 251-7.

  47. Hasegawa T, Kondziolka D, Hadjipanayis CG, Lunsford LD. Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery 2004; 54(4): 813-20; discussion 820-2.

  48. Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: A study of 122 surgical cases. J Neurosurg 2002; 97: 3-11.

  49. Fahlbusch R, Honegger J, Paulus W, et al. Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 1999; 90: 237-50.

  50. Abe T, Ludecke DK. Transnasal surgery for infradiaphragmatic craniopharyngiomas in pediatric patients. Neurosurgery 1999; 44: 957-66.

  51. Wang K-C, Kim S-K, Choe G, Chi JG, Cho B-K. Growth patterns of craniopharyngioma in children: Role of the diaphragm sellae and its surgical implication. Surg Neurol 2002; 57: 25-33.

  52. Shirane R, Su CC, Kusaka Y, Jokura H, Yoshimoto T. Surgical outcome in 31 patients with craniopharyngiomas extending outside the suprasellar cistern: An evaluation of the frontobasal interhemispheric approach. J Neurosurg 2002; 96: 704-12.




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