Onkologie. 2009:3(3):194-197

The possibilities of neuroendoscopy in the complex therapy of craniopharyngioma

prof. MUDr. Zdeněk Novák CSc¹, MUDr. Jan Chrastina Ph.D¹, MUDr. Věra Feitová², Eva Lžičařová³, Ivo Říha⁴

¹ Neurochirurgická klinika LF MU a FN Brno

² Klinika zobrazovacích metod LF MU, FN u sv. Anny v Brně

³ Oddělení patologické anatomie MOÚ, Brno

⁴ Ústav biomedicínského inženýrství, FEKT VUT, Brno

Study aim: The paper presents experience with neuroendoscopic surgery of 5 patients with craniopharyngioma and 2 patients with

Rathke cleft cyst.

Methods: With an exception of one patient (ectopic posterior fossa tumor after multiple surgeries for primary parasellar lesion) the

tumor affected structures around the third ventricle. The principles of navigated transventricular neuroendoscopic surgery were cyst

fenestration and cyst wall resection, reestablishment of cerebrospinal fluid pathways patency or cerebrospinal fluid flow bypass and

solid tumor debulking with utmost attention paid to surrounding structures.

Results: The final outcome was excellent in 3 patients, in one high risk advanced age patient successful surgery led to significant improvement

of performance. The adverse course of one patient suffering from tumor infiltrating hypothalamic structures with symptoms

of hypothalamic dysfunction could not be changed. In two patients referred for surgery as craniopharyngeoma surgical findings and

histology was consistent with Rathke cleft cyst. Clinical course was uneventfull in both patients.

Conclusions: Neuroendoscopic therapy is a part of minimally invasive craniopharyngioma treatment plan making direct tumor surgery

as well as cerebrospinal fluid pathways patency restoration possible. Histological verification is a key requirement for subsequent

complex therapy.

Keywords: craniopharyngioma, neuroendoscopy, neuronavigation.

Published: June 15, 2009  Show citation