Open surgery with total removal represents the first-choice treatment of craniopharyngioma. Unfortunately, the tumor is frequently adherent to delicate and highly functional structures surrounding the tumoral region and so only in few patients an effective total surgical removal can be performed. Children are particularly exposed to post-operative hypothalamic lesions and then an alternative treatment is often preferred, as radiotherapy alone or in association with surgery or stereotactic radiosurgery, with highly focused single dose. In cystic craniopharyngiomas an intracavitary treatment with stereotactic administration of Bleomycin has been proposed to control or delay the growth of cysts, in order to postpone surgery until it is required owing to the increase of the solid portion of the tumor. The rationale of this treatment, particularly useful in childhood, derives from cell kinetics data obtained in these tumors. Since 1986 at Istituto Neurologico "C. Besta" 22 patients affected by cystic craniopharyngioma were treated with stereotactic intracavitary Bleomycin administration. At a follow-up of 5-12 years, treated cysts disappeared in 10 patients and reduced in size or stabilized in all others. 19 patients underwent partial, subtotal or total surgical removal of solid portion of the tumor in the following years. In our opinion intracavitary Bleomycin treatment is an effective means of controlling cystic craniopharyngiomas, especially in children in whom the treatment can delay the surgical removal of the solid portion of the tumor, offering an efficient control over the symptoms related to the cyst's volume.
|Translated title of the contribution||Cystic craniopharyngioma: Stereotactic intracavitary Bleomycin administration|
|Number of pages||5|
|Publication status||Published - 2001|
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