gms | German Medical Science

Objective: Many intracranial cystic lesions, for instance craniopharyngioma, pilocytic astrocytoma or hemangioblastoma, are benign diseases and tend to have a good course following total and subtotal resection. However, invasion degree of operation is high for the midline skull base region or high risk patient such as an aged person. We thought that minimally invasive combination therapy using the neuroendoscope and radiotherapy was useful and report several cases of cystic craniopharyngioma which were treated using this therapy. This report describes the successful of cystic lesions using the neuroendoscope and radiotherapy in our department.

Methods: Between August 2000 to April 2005, 7 patients which had intracranial cystic lesions were operated in our hospital. Four cystic craniopharyngioma and one frontal base pilocytic astrocytoma were treated by hypofractionated stereotactic radiotherapy after volume reduction using neuroendoscope. One malignant lymphoma and one acoustic schwannoma were treated by endoscopic fenestration of cystic changes that resulted from radiotherapy. Especially for cystic acoustic schwannoma, trans-third ventricle, tuber cinereum approach was performed using a fiberscope.

Results: In our series, there were no surgical complications. In 7 patients, almost all cystic lesions are controlled well except one craniopharyngioma which had local recurrence after two years.

Conclusions: The combination treatment using the endoscope and stereotactic radiotherapy may have the advantage of minimally invasiveness for intracranial cystic lesion.