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Craniopharyngioma in children: Marseille experience

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Abstract

Objectives

The management of craniopharyngioma in children represents a challenging problem. If radical excision is recommended by many authors as the initial treatment, in some cases, particularly in recurrent tumours, other methods (gamma knife surgery and intracystic bleomycin) can be very useful. Even if craniopharyngioma is a benign tumour, recurrences are frequent, and the aim of our study was to analyse our results, to try to determine some prognostic factors of recurrences and to discuss about a new strategy concerning the initial management of these tumours.

Methods

Forty-seven children with craniopharyngioma were treated in the Department of Pediatric Neurosurgery. All of the patients, but five children treated by intracystic bleomycin, underwent a surgical resection of the tumour as initial treatment with the goal of achieving gross total removal (GTR) of the tumour. Two children had radiotherapy and gamma knife treatment, respectively, following surgery for a tumoural residue. All the children had a magnetic resonance imaging (MRI) study 3 months after surgery to evaluate the results of the initial treatment. Using statistical analysis, some prognostic factors (age, sex, location, aspect, size of the tumour and result of the first MRI) have been studied.

Results

Forty-two children were operated on, but one died in the immediate postoperative period from a major stroke due to carotid spasm. GTR, defined as the absence of residue on the first MRI control, was achieved in 27 children (65.8%), but 7 patients (25.9%) presented recurrence. Subtotal removal (STR) was obtained in 14 children (34.2%), but 9 patients (64.3%) developed a recurrence defined as the growth of the residual tumour with or without clinical symptoms. Five children having a small- or moderate-size cystic craniopharyngioma were treated using one-stage (three cases) or two-stage (two cases) intracystic bleomycin and any presented recurrence. All the prognostic factors studied, except one (presence of a residue on the first MRI control), do not have a statistical significance.

Conclusion

Craniopharyngioma in children remains a formidable tumour, and regardless of whatever progress made in their management, the incidence of recurrences is still elevated and severe sequelae can be observed. There are no prognostic factors among those studied concerning the recurrences of these tumours except the quality of the exeresis confirmed by the first postoperative MRI.

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References

  1. Adamson TE, Wiestler OD, Kleihues P, Yasargil GD (1990) Correlation of clinical and pathological features in surgically treated craniopharyngiomas. J Neurosurg 73:12–17

    CAS  PubMed  Google Scholar 

  2. Bin-Abbas B, Mawlawi H, Sakati N, Khafaja Y, Chaudhary MA, Al-Ashwal A (2001) Endocrine sequelae of childhood craniopharyngioma. J Pediatr Endocrinol Metab 14:869–874

    CAS  PubMed  Google Scholar 

  3. Broggi G, Giorgi C, Franzini A, Servelo D, Solero CL (1989) Preliminary results of intracavitary treatment of craniopharyngioma with bleomycin. J Neurosurg Sci 33:145–148

    CAS  PubMed  Google Scholar 

  4. Brunel H, Raybaud C, Peretti-Viton P, Lena G, Girard N, Paz-Paredes A, Levrier O, Farnarier P, Manera L, Choux M (2002) Les craniopharyngiomes de l’enfant: Etude en IRM d’une série de 43 cas. Neurochirurgie 48:309–318

    CAS  PubMed  Google Scholar 

  5. Carmel PW, Antunes JL, Chang CH (1982) Craniopharyngiomas in children. Neurosurgery 11:382–389

    CAS  PubMed  Google Scholar 

  6. Cavazzuti V, Fischer E, Welch K, Belli J, Winston K (1983) Neurological and psychophysiological sequelae following different treatments of craniopharyngioma in children. J Neurosurg 59:409–417

    Google Scholar 

  7. Choux M, Lena G, Genitori L (1991) Le Craniopharyngiome de l’Enfant. Neurochirurgie 37(suppl 1):1–174 (French)

    PubMed  Google Scholar 

  8. De Vile CJ, Grant DB, Hayward RD, Stanhope R (1996) Growth and endocrine sequelae of craniopharyngioma. Arch Dis Child 75:108–114

    PubMed  Google Scholar 

  9. De Vile CJ, Grant DB, Kendall BE, Neville BGR, Stanhope R, Watkins KE, Hayward RD (1996) Management of childhood craniopharyngioma: can the morbidity of radical surgery be predicted. J Neurosurg 85:73–81

    Google Scholar 

  10. Duff JM, Meyer FB, Ilstrup DM, Laws ER Jr, Schleck CD, Scheithauer BW (2000) Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291–305

    Article  PubMed  Google Scholar 

  11. Falhbuch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:237–250

    CAS  PubMed  Google Scholar 

  12. Fischer EG, Welch K, Shillito J Jr, Winston KR, Tarbell NJ (1990) Craniopharyngiomas in children. Long-term effects of conservative surgical procedures combined with radiation therapy. J Neurosurg 73:534–540

    Google Scholar 

  13. Hayward R (1999) The present and future management of craniopharyngioma. Childs Nerv Syst 15:764–769

    Article  CAS  PubMed  Google Scholar 

  14. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76:47–52

    CAS  PubMed  Google Scholar 

  15. Kim SK, Wang KC, Shin SH, Choe G, Chi JG, Cho BK (2001) Radical excision of pediatric craniopharyngioma: recurrence pattern and pronostic factors. Childs Nerv Syst 17:531–536

    CAS  PubMed  Google Scholar 

  16. Merkant TE, Kiehna EN, Sanford RA, Mulhern RK, Thompson SJ, Wilson MW, Lustig RH, Kun LE (2002) Craniopharyngioma: the St. Jude research hospital experience 1984–2001. Int J Radiat Oncol Biol Phys 53:533–542

    Article  PubMed  Google Scholar 

  17. Mottolese C, Stan H, Hermier M, Berlier P, Convert J, Frappaz D, Lapras C (2001) Intracystic chemotherapy with bleomycin in the treatment of craniopharyngiomas. Childs Nerv Syst 17:724–730

    Article  PubMed  Google Scholar 

  18. Pierre-Kahn A, Brauner R, Rénier D et al (1988) Traitement des craniopharyngiomes de l’enfant: analyse rétrospective de 50 observations. Arch Fr Pediatr 45:163–167

    CAS  PubMed  Google Scholar 

  19. Rajan B, Ashley S, Gorman C, Jose CC, Horwich A, Bloom HJ, Marsh H, Brada M (1993) Craniopharyngioma—a long-term results following limited surgery and radiotherapy. Radiother Oncol 26:1–10

    CAS  PubMed  Google Scholar 

  20. Riva D, Pantaleoni C, Devoti M, Saletti V, Nichelli F, Giorgi C (1998) Late neuropsychological and behavioural outcome of children surgically treated for craniopharyngioma. Childs Nerv Syst 14:179–184

    Article  CAS  PubMed  Google Scholar 

  21. Shapiro K, Till K, Grant DN (1979) Craniopharyngiomas in childhood: a rational approach to treatment. J Neurosurg 50:617–623

    Google Scholar 

  22. Tomita T, McLone DG (1993) Radical resection of childhood craniopharyngiomas. Pediatr Neurosurg 19:6–14

    Google Scholar 

  23. Van Effenterre R, Boch AL (1997) Craniopharyngiomes chez l’adulte et l’enfant. Etude d’une série chirurgicale consécutive de 106 cas. Neurochirurgie 43:187–210

    PubMed  Google Scholar 

  24. Van Effenterre R, Boch AL (2002) Craniopharyngiomas in adults and children. A study of 122 surgical cases. J Neurosurg 97:3–11

    PubMed  Google Scholar 

  25. Werner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D, Shiminski-Maher T, Flamm ES, Epstein FJ, Miller DC (1994) Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 35:1001–1011

    CAS  PubMed  Google Scholar 

  26. Yasargil MD, Curcic M, Kiss M et al (1990) Total removal of craniopharyngioma. Approach and long-term results in 144 patients. J Neurosurg 73:3–11

    CAS  PubMed  Google Scholar 

  27. Zuccaro G, Jaimovich R, Mantese B, Monges J (1996) Complications in paediatric craniopharyngioma treatment. Childs Nerv Syst 12:385–391

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Hôpital des Enfants La Timone, 264, Rue Saint Pierre, 13385, Marseille, Cedex 05, France

    Gabriel Lena, Armando Paz Paredes & Didier Scavarda

  2. Department of Statistics, Hôpital des Enfants La Timone, Marseille, France

    Bernard Giusiano

Authors
  1. Gabriel Lena
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  2. Armando Paz Paredes
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  3. Didier Scavarda
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  4. Bernard Giusiano
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Correspondence to Gabriel Lena.

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Lena, G., Paredes, A.P., Scavarda, D. et al. Craniopharyngioma in children: Marseille experience. Childs Nerv Syst 21, 778–784 (2005). https://doi.org/10.1007/s00381-005-1207-4

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  • DOI: https://doi.org/10.1007/s00381-005-1207-4

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