Intracystic treatments for craniopharyngioma

Abstract

<jats:p>Craniopharyngioma is a benign tumor histopathologically and in theory should be curable by radical resection. In practice, this tumor behaves like a chronic disease, with many issues related to the effect of the tumor itself and the various treatments on the adjacent structures, such as the pituitary stalk and gland, hypothalamus, visual apparatus, and suprasellar arteries. A multimodality approach to the management of these tumors may produce the optimal outcome, balancing disease control and quality of life. In this paper, the role of intracystic therapies is reviewed, with the major focus on intracystic bleomycin and interferon-α.</jats:p>

Management of craniopharyngiomas: Role of conservative strategies

“…[24] Cysts can also be controlled by instillation of the cyst with radioactive colloids or chemotherapeutic agents such as bleomycin and IFN. [28][29][30][31][32][33] Other techniques to deliver localized radiation to the craniopharyngioma while minimizing the damage to surrounding vital structures include stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS) and gamma knife radiosurgery. [34] Sainte-Rose et al, based on their finding that quality-of-life was most severely affected when radical surgery was attempted in children having a pre-operative MRI showing invasion of the hypothalamus by the craniopharyngioma (Type 2), recommended conservative surgery preserving the hypothalamic region followed by RT in such patients.…”

“…[58] In contrast Steinbok and Hukin have noted tumor progression in 2 patients as long as 8 and 10 years after excellent responses to bleomycin. [33] In general, ICB is delivered through a subgaleal Ommaya reservoir connected to a catheter, the tip of which with all its holes is positioned within the cyst cavity. Placement of the catheter is either through an open craniotomy under direct vision or endoscopic guided or stereotactic guided.…”

Atualização terapêutica no tratamento dos craniofaringiomas

“…A terapia com radioisótopos não é livre de complicações, sendo descritas complicações graves como grave déficit visual e hipopituitarismo secundário em até 50% dos pacientes (32).…”

“…Essa substância é um antibiótico que atua em carcinomas de células escamosas, interferindo na replicação do DNA tumoral, levando à diminuição da produção de liquor e degeneração celular (32,34).…”

Intracystic interferon-α treatment leads to neurotoxicity in craniopharyngioma: case report

“…In tracystic therapies are often considered because cysts are a predominant feature in more than 90% of these tumors and provide a reservoir into which antineoplastic agents can be delivered. 16 Interferon (IFN)a has been gaining popularity as an intracystic therapy for craniopharyngioma as a result of its efficacy and supposed benign toxicity profile. 4 How ever, in the current case report we describe a patient who, while receiving intracystic IFNa, suffered a neurological event, which was believed to be related to drug leakage outside the cyst.…”