Skip to main content
SpringerLink
Log in

Purely neuroendoscopic transventricular management of cystic craniopharyngiomas

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

This paper reports our series of cystic craniopharyngiomas treated using a purely neuroendoscopic approach.

Methods

Drainage and wide marsupialization into CSF spaces (cysto-ventriculo-cisternostomy) were achieved to ensure mass effect control, continuous dilution, and reabsorption of the cyst’s fluid. A steerable, flexible neuroendoscope and a pre-coronal approach were used in 7 patients harboring intra/paraventricular cysts (4 primary and 3 recurrent).

Results

These surgical goals were achieved in all but one case and no procedure-related complications were observed. During the follow-up period (range 6–72 months; average 38.3 months) one recurrence and one progression of undrained pouch were observed at 25 and 30 months. Both patients underwent successful repeat neuroendoscopy.

Conclusions

In our hands, this technique has proven minimally invasive, safe, and effective; although oncologically palliative it can be implemented with other therapeutic modalities. Our preliminary experience should stimulate the recruitment of larger groups of patients in order to define the role of neuroendoscopy in the multimodal treatment of craniopharyngiomas.

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

Fig. 1a–c
Fig. 2a, b
Fig. 3a, b

Similar content being viewed by others

References

  1. Abdullah J, Camaert J (1995) Endoscopic management of craniopharyngiomas: a review of 3 cases. Minim Invasive Neurosurg 38:79–84

    CAS  PubMed  Google Scholar 

  2. Broggi G, Giorgi C, Franzini A, Servello D, Solero CL (1989) Preliminary results of intracavitary treatment of craniopharyngioma with bleomycin. J Neurosurg Sci 33:145–148

    CAS  PubMed  Google Scholar 

  3. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner J (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551

    CAS  PubMed  Google Scholar 

  4. Carpentieri SC, Waber DP, Scott RM (2001) Memory deficits among children with craniopharyngiomas. Neurosurgery 49:1053–1058

    Article  CAS  PubMed  Google Scholar 

  5. Duff JM, Meyer FB, Ilstrup DM, Laws ER, Schleck CD, Scheitauer BW (2000) Long term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291–305

    PubMed  Google Scholar 

  6. Fahlbush R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:237–250

    PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  8. Gordy PG, Peet MM, Kahn EA (1949) The surgery of craniopharyngioma. J Neurosurg 6:503–517

    Google Scholar 

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

    CAS  PubMed  Google Scholar 

  10. Haisa T, Ueki K, Yoshida S (1994) Toxic effects of bleomycin on the hypothalamus following its administration into a cystic craniopharyngioma. Br J Neurosurg 8:747–750

    CAS  PubMed  Google Scholar 

  11. Honegger J, Buchfelder M, Fahlbush R (1999) Surgical treatment of craniopharyngiomas: endocrinological results. J Neurosurg 90:251–257

    CAS  PubMed  Google Scholar 

  12. Ito M, Jamshidi J, Yamanaka K (2001) Does craniopharyngioma metastasize? Case report and review of the literature. Neurosurgery 48:933–936

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  14. Nakamizo A, Inamura T, Nishio S, Inoha S, Ishibashi H, Fukui M (2001) Neuroendoscopic treatment of cystic craniopharyngioma in the third ventricle. Minim Invasive Neurosurg 44:85–87

    Article  CAS  PubMed  Google Scholar 

  15. Savas A, Erdem A, Tun K, Kanpolat Y (2000) Fatal toxic effect of bleomycin on brain tissue after intracystic chemotherapy for craniopharyngioma: case report. Neurosurgery 46:213–217

    CAS  PubMed  Google Scholar 

  16. Shapiro B, Fig LM, Gross MD (1999) Intracavitary therapy of craniopharyngiomas. Q J Nucl Med 43:367–374

    CAS  PubMed  Google Scholar 

  17. Spaziante R, de Divitiis E (1997) Drainage techniques for cystic craniopharyngiomas. Neurosurg Q 7:183–208

    Google Scholar 

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

    CAS  PubMed  Google Scholar 

  19. Voges J, Sturm V, Lehrke R, Treuer H, Gauss C, Berthold F (1997) Cystic craniopharyngioma: long term results after intracavitary irradiation with stereotactically applied colloidal B-emitting radioactive sources. Clinical study. Neurosurgery 40:1992–1998

    Google Scholar 

  20. Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P (1990) Total removal of craniopharyngiomas. J Neurosurg 73:3–11

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. U.O. di Neurochirurgia, Dipartimento di Neuroscienze “G.M. Lancisi”, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy

    Alberto Delitala, Andrea Brunori & Francesco Chiappetta

Authors
  1. Alberto Delitala
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Brunori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francesco Chiappetta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Brunori.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Delitala, A., Brunori, A. & Chiappetta, F. Purely neuroendoscopic transventricular management of cystic craniopharyngiomas. Childs Nerv Syst 20, 858–862 (2004). https://doi.org/10.1007/s00381-004-0943-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-004-0943-1

Keywords

Search

Navigation