CT appearances of craniopharyngiomas before and after therapy

Different means of therapy are available for the treatment of craniopharyngiomas (surgery, radiation therapy, radioactive implants) but their respective impact is still a matter of controversy. Computed tomographic examinations of 26 patients before and after various forms of therapy were used to monitor the efficacy of treatment. 118 scans were retrospectively studied for characteristic features. 16 patients were treated by surgery and additional radiotherapy, 10 had surgery alone. The total size of the tumour was found to be decreased in 69% of patients treated by incomplete surgery and irradiation up to 9 years after treatment, while tumor progression occurred in three patients. Where the surgeon considered that there had been excision of the lesion, evidence of residual tumour was seen in 4/8 (50%) of cases, but no regrowth occurred in these whose postoperative scans had indicate complete resection. The increase or development of calcification after radiotherapy is compatible with a silent tumour.