gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Treatment of craniopharyngeomas: results of transcranial surgery between 2000 and 2004

Therapie von Craniopharyngeomen: Ergebnisse transkranieller Operationen zwischen 2000 und 2004

Meeting Abstract

Suche in Medline nach

  • corresponding author J. Flitsch - Neurochirurgische Klinik, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg
  • G. Kammler - Neurochirurgische Klinik, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg
  • U. Kehler - Neurochirurgische Klinik, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg
  • M. Westphal - Neurochirurgische Klinik, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-07.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0199.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Flitsch et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Craniopharyngeomas are usually slow-growing, histologically benign tumours developing from remnants of Rathke’s pouch. Incomplete surgical resection is frequently reported and can lead to recurrences. Pituitary deficiencies are common; hypothalamic imbalances after surgery like hyperphagia are feared complications. We report our results of transcranial surgeries for craniopharyngeomas between 2000 and 2004.

Methods

Forty-two patients were treated for craniopharyngeomas in our institution between 2000 and 2004, of whom 20 patients (11 females) were operated on via the transcranial approach for suprasellar lesions. The charts were reviewed for neurological and endocrinological symptoms, duration of symptoms prior to diagnosis, MRI findings, surgical results, outcome and follow-up.

Results

Six patients were age 18 or younger (30%). Neurologically, 11 patients complained of headaches, 13 of visual disturbances prior to diagnosis, 2 patients became hydrocephalic. Endocrinologically, pubertas praecox was found in 1 child, the other 5 children (83%) presented with growth retardation. In adults, 8 patients presented with gonadotrophic insufficiency (57%), 2 patients (14%) with panhypopituitarism, 4 patients (28%) presented with intact pituitary function. Average tumour diameter was 31 mm, ranging from 12-70 mm. Four tumour resections were classified microsurgically complete (20%), in 16 cases (80%) incomplete resection was performed. Neurologically, visual disturbances improved in all but 1 patient. Endocrinologically, only 3 patients (15%) did not show decrease of pituitary functions, in 2 patients diabetes insipidus occurred, 3 patients showed decrease in one pituitary axis, in 3 complete anterior pituitary lobe functions were lost. Nine patients showed panhypopituitarism (45%). Surgical complications included 2 ischemic lesions. In 4 patients (20%) hypothalamic disturbances in the sense of hyperphagia was found. So far, 9 patients needed additional surgical or radiation therapy (45%).

Conclusions

In craniopharyngeomas, the first therapeutic step of treatment is surgical resection. For suprasellar lesions, transcranial surgery is the preferred approach. Endocrinological and neurological morbidity has to be considered. In the majority of patients only incomplete resection with the need for further treatment can be achieved. Interdisciplinary cooperation of pediatricians, endocrinologists, radiotherapists, and neurosurgeons is therefore needed. A careful follow-up is mandatory.