Summary
Fourteen children and 3 adults with cystic craniopharyngiomas were treated with intracavitary 90Y, by the procedure described by Backhand. Their ages ranged from 2 to 65 years and postoperative follow-up ranged from 6 to 40 months. Leksel’s stereotactic technique was employed to determine coordinates by CAT. Cyst volume was quantified both geometrically and isotopically with 99Tc, values differing by 7%. Dosimetry was determined by applying the formula developed by Loevinger et al., and 20,000 rads were administered throughout to the cystic wall. All 17 patients, except for 4 children, had previously received surgery, shunts or radiotherapy, alone or combined. In 4 cases,90Y injection was the only treatment, while in 6, the cyst was evacuated at 10 days following radiocolloid injection. Skull and spinal column gamma chamber studies were carried out on all patients at 24, 48, and 72 hours post injection, but no isotope leakage could be detected. The patients returned to normal activities except one with multiple cysts who died. There were no changes in the endocrinologic profile. In one case, a decrease in visual acuity 18 months after treatment, improved following corticoid administration.
Conclusions: Though preliminary, these results are encouraging since it seems that the severe neuro-endocrinologic sequelae of open surgery may be avoided.
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References
Backlund EO (1972) Studies on craniopharyngiomas. I. Treatment past and present. Acta Chir Scand 138: 743–747.
Backlund EO, Johansson L, Sarby B (1972) Studies on craniopharyngiomas. II. Treatment by stereotaxic and radio-surgery. Acta Chir Scand 138: 749–759.
Backlund EO (1973) Studies on craniopharyngiomas. III. Stereotaxic treatment with intracystic 90Yttrium. Acta Chir Scand 139: 237–247.
Backlund EO (1973) Studies on craniopharyngiomas. IV. Stereotaxic treatment with radiosurgery. Acta Chir Scand 139: 344–351.
Cavazzutti V, Fischer EG, Welch K, Belli JA, Winston KR (1983) Neurological and psychophysiological sequelae following different treatment of craniopharyngiomas in children. J Neurosurg 59: 409–417.
Fischer EG, Welch K, Belli JA, Wallman J, Shillito J, Winston KR, Cassady R (1985) Treatment of craniopharyngiomas in children: 1972–1981. J Neurosurg 62: 496–501.
Hoff JT, Patterson RH (1972) Craniopharyngiomas in children and adults. J Neurosurg 36: 299–302.
Hoffman HJ, Hendrick EB, Humphreys RP et al (1977) Management of craniopharyngioma in childhood. J Neurosurg 47:218–227.
Julow J, Langi F, Hajda M, Simkovics M, Arany I, Toth SA, Pastor E (1985) The radiotherapy of cystic craniopharyngioma with intracystic installation of 90Y silicate colloid. Acta Neurochir (Wien) 7: 94–99.
Kahn EA, Gosch HH, Seeger JF et al (1973) Forty-five years experience with the craniopharyngiomas. Surg Neurol 1: 5–12.
Kobayashi T, Kageyama N, Ohara K (1981) Internal irradiation for cystic craniopharyngioma. J Neurosurg 55: 896–903.
Kodama T, Marsukado Y, Uemura S (1981) Intracapsular irradiation therapy of craniopharyngiomas with radioactive gold. Neurol Med Chir (Tokyo) 21: 39–58.
Leksell L, Liden K (1951) A therapeutic trial with radioactive isotopes in cystic brain tumour. In: Radioisotope techniques, voll. Proc. Isotope. Techniques Confer. Oxford. July 1957. H. M. Stationery Office, London.
Leksell L, Backlund EO, Johansson L (1967) Treatment of craniopharyngiomas. Acta Chir Scand 133: 345–350.
Liwnicz BH, Berger TS, Wiwnics RG, Aron BS (1985) Radiation associated gliomas: a reporte of four cases and analysis of postradiation tumours of the central nervous system. Neurosurgery 17: 436–445.
Loevinger R, Japha EM, Brownell GL (1956) In: Hine and Brownell (eds) Radiation dosimetry. Academic Press, New York.
Lunsford LD, Levine G, Gumeran L (1985) Comparison of computerized tomographic and radionucleide methods in determining intracranial cystic tumour volumes. J Neurosurg 63:740–744.
Mori K, Taketschi J, Ishikawa M, Handa H, Toyama M, Yamaki T (1978) Occlusive arteriopathy and brain tumour. J Neurosurg 49: 22–35.
Russell DS, Rubinstein LJ (1977) Pathology of tumours of the nervous system. 4th edit. Arnold, London, 448 p.
Shapiro K, Till K, Grant DN (1979) Craniopharyngiomas in childhood: A rational approach to treatment. J Neurosurg 50:617–623.
Shillito J (1976) Treatment of craniopharyngioma of childhood. In: Morley TP (ed) Current controversies in neurosurgery. WB Saunders, Philadelphia, pp 332–336.
Shillito J Jr (1985) Treatment of craniopharyngioma. Clin Neurosurg 33: 533–546.
Sundaresan N, Galicich JH, Deck MDF et al (1981) Radiation necrosis after treatment of solitary intracranial metastases. Neurosurgery 8: 329–333.
Thomsett MJ, Conte FA, Kaplan SL, Grumbach MM (1980) Endocrine and neurologic outcome in childhood craniopharyngioma: Review of effect of treatment in 42 patients. J Pediatr 97: 728–735.
Zülch KJ (1965) Brain tumours, their biology and pathology, 2nd edit. Springer, Wien, pp 213–218.
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Guevara, J.A., Bunge, H.J., Heinrich, J.J., Weller, G., Villasante, A., Chinela, A.B. (1988). Cystic Craniopharyngioma Treated by 90Yttrium Silicate Colloid. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_22
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DOI: https://doi.org/10.1007/978-3-7091-8975-7_22
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