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Published on: June 28, 2024
[Treatment of craniopharyngiomas in children]
Keiichi Sakai1, Yuichiro Tanaka, Kazuhiro Hongo
1Department of Neurosurgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621 Japan. skeiichi@hsp.md.shinshu-u.ac.jp
Insights
This 25-year study of pediatric craniopharyngioma found good outcomes in 11 of 12 children. Effective treatment combines surgery, conventional radiotherapy, and gamma knife radiosurgery for optimal results.
Area of Science:
- Pediatric neurosurgery
- Pediatric oncology
- Radiation oncology
Background:
- Craniopharyngiomas are rare tumors affecting children.
- Long-term outcomes in pediatric craniopharyngioma require further investigation.
Observation:
- A retrospective study reviewed 12 children under 15 treated for craniopharyngioma between 1978 and 2002.
- The median age at resection was 7.3 years, with a mean follow-up of 132 months.
Findings:
- Overall good outcomes were observed in 11 of 12 patients.
- Four patients experienced tumor recurrence, necessitating further treatment with conventional radiotherapy or gamma knife radiosurgery.
- All patients required postoperative hormonal replacement, with occasional recovery from pituitary dysfunction possible.
Implications:
- Multimodal treatment, including surgery, conventional radiotherapy, and gamma knife radiosurgery, can achieve optimal functional outcomes.
- Regular MRI follow-up is crucial, even after apparent complete tumor resection.
- The goal of treatment is complete tumor removal with minimal morbidity.
Purpose:
The purpose of this article is to assess, in a 25-year retrospective study, the clinical outcome in children with craniopharyngioma.
Patient And Methods:
From 1978 to 2002, 12 children younger than 15-year-old underwent treatment with surgery and/or radiotherapy for craniopharyngioma. The clinical course and outcome were reviewed.
Results:
The median age was 7.3 years (range, 3 to 12 years) at the time of initial surgical resection. With a mean follow-up period of 132 months (range, 29 to 255 months), 1 patient died of tumor progression due to malignant transformation at 205 months after the initial surgery and the overall outcome was good in 11 patients. Out of 12 patients 4 presented a recurrence of their tumor, 2 after an apparently gross total removal. Because of tumor recurrence, 2 received conventional radiation therapy and 3 received gamma knife radiosurgery. There was neither operative mortality nor major complication. All patients required hormonal replacement postoperatively.
Conclusions:
The goal in the treatment of craniopharyngiomas is to achieve total removal without morbidity. Our results compared favorably with the previous reports in the literature. MRI follow-up should be performed even in patients whose primary tumor is resected "completely". Suitable combination of open surgery, conventional radiotherapy and gamma knife radiosurgery may result in optimal functional outcome. Recovery from postoperative pituitary dysfunction can be occasionally expected.
