Skip to main content
SpringerLink
Log in

Management of primary or recurring grossly cystic craniopharyngiomas by means of draining systems

Topic review and 6 case reports

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

In primary or relapsing grossly cystic craniopharyngiomas most of the problems related to the neoplastic mass may be, even if temporarily, improved by reducing volume of the cyst. A major surgical approach is unjustified when the aim is only to empty the cyst contents. Drainage of the cyst cavity by means of derivative techniques may be as effective and less invasive; in combined management plans that such tumours often require, they are, therefore, useful complementary procedures that can achieve long-lasting relief of symptoms, provided that the cyst is unilocular.

Technical features and indications for such methods, with special regard to the techniques of sump drainage and of tube ventriculocystostomy, are discussed on the basis of the few reported series and of 6 personal cases. Usually only palliative aims are achieved, waiting for more definitive treatment; in a few selected cases, however, they may be quite effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Al Mefty O, Hassounah M, Sakati N, Jinkins JR, Fox JL (1985) Microsurgery for giant craniopharyngiomas in children. Neurosurgery 17: 585–595

    PubMed  Google Scholar 

  2. Backlund EO (1973) Studies on craniopharyngiomas. III. Stereotaxic treatment with intracystic yttrium-90. Acta Chir Scand 139: 237–247

    PubMed  Google Scholar 

  3. Backlund EO, Johansson L, Sarby B (1972) Studies on craniopharyngiomas. II. Treatment by stereotaxis and radiosurgery. Acta Chir Scand 138: 749–759

    PubMed  Google Scholar 

  4. Bartlett JR (1971) Craniopharyngioma — a summary of 85 cases. J Neurol Neurosurg Psychiatry 34: 37–41

    PubMed  Google Scholar 

  5. Baskin DS, Wilson CB (1986) Surgical management of craniopharyngiomas. A review of 74 cases. J Neurosurg 65: 22–27

    PubMed  Google Scholar 

  6. Bloom HJG (1977) The role of radiotherapy in the management of chiasmal compression. Proc R Soc Med 70: 319–326

    PubMed  Google Scholar 

  7. Bond WH, Richards D, Turner E (1965) Experiences with radioactive gold in the treatment of craniopharyngioma. J Neurol Neurosurg Psychiatry 28: 30–38

    PubMed  Google Scholar 

  8. Braun IF, Pinto RS, Epstein F (1982) Dense cystic craniopharyngiomas. AJNR 3: 139–142

    PubMed  Google Scholar 

  9. Cabezudo JM, Vaquero J, Areitio E, Martinez R, De Sola GR, Bravo G (1981) Craniopharyngiomas: a critical approach to treatment. J Neurosurg 55: 371–375

    PubMed  Google Scholar 

  10. Carmel PW (1985) Craniopharyngiomas. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, vol 1. McGraw-Hill, New York, pp 905–916

    Google Scholar 

  11. Carmel PW, Antunes JL, Chang CH (1982) Craniopharyngiomas in children. Neurosurgery 11: 382–389

    PubMed  Google Scholar 

  12. Cavazzuti V, Fisher EG, Welch K, Belli JA, Winston KR (1983) Neurological and psychophysiological sequelae following different treatments of craniopharyngioma in children. J Neurosurg 59: 409–417

    PubMed  Google Scholar 

  13. Djordjevic M, Djordjevic Z, Janicijevic M, Nestorovic B, Stefanovic B, Ikov M (1979) Surgical treatment of craniopharyngiomas in children. Acta Neurochir (Wien) [Suppl] 28: 344–347

    Google Scholar 

  14. Fisher EG, Welch K, Belli JA, Wallman J, Shillito J Jr, Winston KR, Cassady R (1985) Treatment of craniopharyngiomas in children: 1972–1981. J Neurosurg 62: 496–501

    PubMed  Google Scholar 

  15. Fox JL (1967) Intermittent drainage of intracranial cyst via the subcutaneous Ommaya reservoir. Technical note. J Neurosurg 27: 272–273

    PubMed  Google Scholar 

  16. Garcia-Uria J (1978) Surgical experience with craniopharyngioma in adults. Surg Neurol 9: 11–14

    PubMed  Google Scholar 

  17. Guidetti B, Fraioli B (1979) Craniopharyngiomas: results of surgical treatment. Acta Neurochir (Wien) [Suppl] 28: 349–351

    Google Scholar 

  18. Gutin PH, Klemme WL, Lagger RL, Mackay AR, Pitts LH, Hosobuchi Y (1980) Management of unresectable cystic craniopharyngioma by aspiration through an Ommaya reservoir drainage system. J Neurosurg 52: 36–40

    PubMed  Google Scholar 

  19. Hardy J (1971) Transsphenoidal hypophysectomy. J Neurosurg 34: 582–594

    PubMed  Google Scholar 

  20. Heifetz MD, Wexler M, Thompson R (1984) Single beam radiotherapy knife. A practical theoretical model. J Neurosurg. 60: 814–818

    PubMed  Google Scholar 

  21. Hoff JT, Patterson RH Jr (1972) Craniopharyngiomas in children and adults. J Neurosurg 36: 299–302

    PubMed  Google Scholar 

  22. Hoffman HJ, Hendrick EB, Humphreys RP, Buncic JR, Armstrong DL Jenkin RDT (1977) Management of craniopharyngioma in children. J Neurosurg 47: 218–227

    PubMed  Google Scholar 

  23. Huk WJ, Mahldstedt J (1983) Intracystic radiotherapy (Y90) of craniopharyngiomas: CT-guided stereotaxic implantation of indwelling drainage system. AJNR 4: 803–806

    PubMed  Google Scholar 

  24. Ignelzi RJ, Squire LR (1976) Recovery from anterograde and retrograde amnesia after percutaneous drainage of a cystic craniopharyngioma. J Neurol Neurosurg Psychiatry 39: 1231–1235

    PubMed  Google Scholar 

  25. Kahn EA, Gosch HH, Seeger JF, Hicks SP (1973) Forty-five years experience with the craniopharyngiomas. Surg Neurol 1: 5–12

    PubMed  Google Scholar 

  26. Kjellberg RN (1979) Craniopharyngiomas. In: Tindall GT, Collins WF (eds) Clinical management of pituitary disorders. Raven Press, New York, pp 373–388

    Google Scholar 

  27. Kobayashi T, Kageyama N, Ohara K (1981) Internal irradiation for cystic craniopharyngioma. J Neurosurg 55: 896–903

    PubMed  Google Scholar 

  28. Kramer S, Southard M, Mansfield CM (1968) Radiotherapy in the management of craniopharyngiomas. Further experiences and late results. AJR 103: 44–51

    Google Scholar 

  29. Laws ER Jr (1980) Transsphenoidal microsurgery in the management of craniopharyngiomas. J Neurosurg 52: 661–666

    PubMed  Google Scholar 

  30. Leksell L., Backlund EQ, Johansson L (1967) Treatment of craniopharyngiomas. Acta Chir Scand 133: 345–350

    PubMed  Google Scholar 

  31. Leksell L, Liden C (1953) A therapeutic trial with radioactive isotopes in cystic brain tumour. In: Radioisotopes techniques, vol 1. HM Stationary Office, Oxford

    Google Scholar 

  32. Manaka S, Teramoto A, Takakura K (1985) The efficacy of radiotherapy for craniopharyngioma. J Neurosurg 62: 648–656

    PubMed  Google Scholar 

  33. Mann KS, Yue CP, Ong GB (1983) Percutaneous sump drainage: a palliation for oft-recurring intracranial cystic lesions. Surg Neurol 19: 86–90

    PubMed  Google Scholar 

  34. Matson DD, Crigler JF Jr (1969) Management of craniopharyngioma in childhood. J Neurosurg 30: 377–390

    PubMed  Google Scholar 

  35. Miles J (1977) Sump drainage: a palliative manoeuvre for the treatment of craniopharyngioma. J Neurol Neurosurg Psychiatry 40: 120–126

    PubMed  Google Scholar 

  36. Mokrusch T, Schramm J, Fahlbusch R (1985) Repeatedly reversible alteration of acoustic evoked brainstem responses with a cystic craniopharyngioma. Surg Neurol 24: 571–577

    PubMed  Google Scholar 

  37. Mori K, Handa H, Murata T, Takeuchi J, Miwa S, Osaka K (1980) Results of treatment of craniopharyngioma. Child's Brain 6: 303–312

    PubMed  Google Scholar 

  38. Müller PJ, Russell NA, Morley TP (1976) Craniopharyngioma: results of surgical treatment without radiotherapy. In: Morley TP (ed) Current controversies in neurosurgery. WB Saunders Co, Toronto, pp 344–350

    Google Scholar 

  39. Oh SY (1973) Rickham Klappen-Drainage bei rezidivierendem zystischem Kraniopharyngiom. Schweiz Arch Neurol Neurochir Psychiatry 113: 57–72

    Google Scholar 

  40. Overton MC III, Sheffel DD (1963) Recurrent cystic formation in craniopharyngioma treated with radioactive chromic phosphate. J Neurosurg 20: 707–710

    PubMed  Google Scholar 

  41. Richmond IL, Wara WM, Wilson CB (1980) Role of radiation therapy in management of craniopharyngiomas in children. Neurosurgery 6: 513–517

    PubMed  Google Scholar 

  42. Rougerie J (1979) What can be expected from the surgical treatment of craniopharyngiomas in children: report of 92 cases. Child's Brain 5: 433–449

    PubMed  Google Scholar 

  43. Scarff JE (1941) A new method for treatment of cystic craniopharyngioma by intraventricular drainage. Arch Neurol Psychiatry 46: 843–867

    Google Scholar 

  44. Shapiro K, Till K, Grant DN (1979) Craniopharyngiomas in childhood: a rational approach to treatment. J Neurosurg 50: 617–623

    PubMed  Google Scholar 

  45. Shillito J Jr (1980) Craniopharyngiomas: the sub-frontal approach or none at all? Clin Neurosurg 27: 188–205

    PubMed  Google Scholar 

  46. Strauss L, Sturm V, Georgi P, Schlegel W, Ostertag H, Clorius JH, Van Kaick G (1982) Radioisotopes therapy of cystic craniopharyngiomas. Int J Radiation Oncology Biol Phys 8: 1581–1585

    Google Scholar 

  47. Sung DI, Chang CH, Harisiadis L, Carmel PW (1981) Treatment results of craniopharyngiomas. Cancer 47: 847–852

    Google Scholar 

  48. Sweet WH (1976) Radical surgical treatment of craniopharyngiomas. Clin Neurosurg 23: 52–79

    PubMed  Google Scholar 

  49. Sweet WH (1980) Recurrent craniopharyngiomas: therapeutic alternatives. Clin Neurosurg 27: 206–229

    PubMed  Google Scholar 

  50. Symon L, Sprich W (1985) Radical excision of craniopharyngioma. Results in 20 patients. J Neurosurg 62: 174–181

    PubMed  Google Scholar 

  51. Takahashi H, Nazakawa S, Shimura T (1985) Evaluation of postoperative intratumoral injection of bleomycin for craniopharyngioma in children. J Neurosurg 62: 120–127

    PubMed  Google Scholar 

  52. Taylor JC (1971) Craniopharyngioma. J Neurol Neurosurg Psychiatry 34: 105

    Google Scholar 

  53. Trippi AC, Garner JT, Kassabian JT, Shelden CH (1969) A new approach to inoperable craniopharyngiomas. Am J Surg 118: 307–310

    PubMed  Google Scholar 

  54. Villarejo FJ (1982) Recurrence in craniopharyngiomas. Neurochirurgia 25: 73–74

    PubMed  Google Scholar 

  55. Wakamatsu T, Katsuo T, Kwano S, Teramoto S, Matsumura H (1971) Glioblastoma with extracranial metastasis through ventriculo-pleural shunt. J Neurosurg 34: 697–701

    PubMed  Google Scholar 

  56. Wilson CB (1979) Current concepts in cancer: brain tumors. N Engl J Med 300: 1469–1471

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istituto di Neurochirurgia, Cattedra di Neurochirurgia Funzionale, 2 Facoltà di Medicina e Chirurgia, Università di Napoli, Napoli, Italy

    R. Spaziante, E. De Divitiis, C. Irace, P. Cappabianca & F. Caputi

Authors
  1. R. Spaziante
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. De Divitiis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Irace
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Cappabianca
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Caputi
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Partly communicated to the 35th Congress of the Italian Society of Neurosurgery, Pavia, September 17–20, 1986 and to the 8th European Congress of Neurosurgery, Barcelona, Spain, September 6–11, 1987.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Spaziante, R., De Divitiis, E., Irace, C. et al. Management of primary or recurring grossly cystic craniopharyngiomas by means of draining systems. Acta neurochir 97, 95–106 (1989). https://doi.org/10.1007/BF01772817

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01772817

Keywords

Search

Navigation