The role of transventricular neuroendoscopy in the management of craniopharyngiomas: three patient reports and review of the literature.

BACKGROUND: Management of craniopharyngiomas is problematic and often requires multimodal protocols. In the last decade neuroendoscopy has been increasingly used in the management of these lesions. PATIENT REPORTS: We report three cases of craniopharyngiomas in which various endsocopic procedures were performed. In the first case the endoscopic approach alone allowed the gross total removal of an intraventricular craniopharyngioma; in the second case the endoscopic fenestration of a cystic intraventricular craniopharyngioma allowed long-term control of the tumor with no further treatment; in the third case endoscopic fenestration and drainage of the cystic part allowed collapse of the cyst with resolution of mass effect on the visual pathway and control of hydrocephalus. The patient later underwent microsurgical removal of the solid portion of the tumor.
CONCLUSIONS: Neuroendoscopy has shown great versatility in the management of intra/paraventricular craniopharyngiomas. It can be used alone to achieve gross total removal or marsupialization of cystic tumors, or, more often, in association with additional therapies, such as microsurgery, radiosurgery or intracavitary drug administration.