Visual Field Loss in a Case of Recurrent Cystic Craniopharyngioma During Concomitant Treatment With Pegylated Interferon α-2b

Abstract

A 13-year-old male with suprasellar cystic craniopharyngioma initially controlled with sequential subtotal resections and proton-beam irradiation was later treated with intracystic pegylated interferon α-2b due to progression and a lack of further surgical options. After initial successful control of recurrent cyst enlargement and stabilization of the ophthalmic examination, progressive and irreversible visual field loss ensued. Imaging revealed intracranial leakage from the intracystic catheter, and direct administration of interferon α-2b was discontinued. Given the recent interest in interferon α-2b, oncologists are advised to vigilantly monitor patients for signs of local toxicity that may result from unintended leakage during intracystic delivery.

Feasibility, tolerability, and first experience of intracystic treatment with peginterferon alfa-2a in patients with cystic craniopharyngioma

“…Case 5 demonstrated the importance of pursuing a permeability study at least 2 weeks postoperatively and prior to the start of intracystic treatment to rule out leakage, most likely the cause of patient’s systemic toxicities ( 40 ). One case report of a 13-year-old patient treated with intracystic plus concomitantly subcutaneous pegylated interferon alfa-2b ( 41 ) described irreversible visual field loss and confirmed leakage from the intracystic catheter via computed tomographic imaging as the cause.…”

Intracystic interferon-alpha in pediatric craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and ISPN

“…Although not observed in the larger cohort analyses, similar case reports of significant toxicity following intracystic interferon-alpha administration in craniopharyngioma are now emerging, secondary to drug extravasation into CSF spaces. 45,46 In one report, a craniopharyngioma patient suffered a focal neurological event, with subsequent permeability imaging revealing suspected cyst rupture, 45 while another described a 13-year-old patient with recurrent, cystic craniopharyngioma who developed permanent visual field loss and reversible acuity decline following the concomitant administration of intracystic and subcutaneous pegylated interferon-alpha. 46 Retrospective permeability imaging revealed a cyst wall leak.…”

Treatment methods of craniopharyngioma and its complications with a particular emphasis on obesity

“…Powikłania terapii, tj. gorączka, uczucie zmęczenia, utrata łaknienia, spadek masy ciała, depresja, niedokrwistość, trombocytopenia, neutropenia, hipertransaminazemia, obserwowano u 1/3 pacjentów, sporadycznie występują poważne powikłania: obrzęk tarczy nerwu wzrokowego, wylew w obrębie dna oka, niedokrwienna neuropatia nerwu wzrokowego, atrofia mózgu, utrata wzroku [82][83][84][85][86].…”