Adrián Cáceres1. 1. Neurosurgery, National Children's Hospital, San José, Costa Rica. ACaceresc@hnn.sa.cr
Abstract
BACKGROUND: Craniopharyngioma remains an entity of controversial management due to its critical anatomical relationships and its well-known recurrence tendency. Total resection, although desirable, is not always accomplished, and it is associated with potentially permanent endocrinological and visual deficits. Consequently, this situation has led to the development of new management strategies seeking lesser morbidity. Because a high percentage of these lesions are cystic, bleomycin and radioactive-emitting sources have been postulated as new therapeutic options with promising results. DISCUSSION: The information known to date regarding these substances is summarized and we perform a retrospective review of the clinical trials conducted over the past 30 years with special emphasis on outcome, morbidity, and mortality. Two cases from our institution are presented as examples of multimodality management. CONCLUSION: Overall, these newer options stand out as valid alternatives in the controversial management of these challenging tumors.
BACKGROUND: Craniopharyngioma remains an entity of controversial management due to its critical anatomical relationships and its well-known recurrence tendency. Total resection, although desirable, is not always accomplished, and it is associated with potentially permanent endocrinological and visual deficits. Consequently, this situation has led to the development of new management strategies seeking lesser morbidity. Because a high percentage of these lesions are cystic, bleomycin and radioactive-emitting sources have been postulated as new therapeutic options with promising results. DISCUSSION: The information known to date regarding these substances is summarized and we perform a retrospective review of the clinical trials conducted over the past 30 years with special emphasis on outcome, morbidity, and mortality. Two cases from our institution are presented as examples of multimodality management. CONCLUSION: Overall, these newer options stand out as valid alternatives in the controversial management of these challenging tumors.
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