[Craniopharyngioma with rapid regrowth--role of MIB-1 labeling index].
The treatment of craniopharyngioma becomes quite difficult when it extends into the third ventricle. In a 4-year-old boy, we encountered a large cystic craniopharyngioma which grew into the third ventricle. Initially, the tumor was successfully removed via a right transcallosal transchoroidal approach. A residual part seemed to have remained in the right perioptic region. Even though the patient had an episode of SIADH, his postoperative course was uneventful. He developed visual disturbance 4 months after the initial operation. CT and MRI revealed a large suprasellar mass. The tumor was totally resected via a right pterional approach. Careful follow-up disclosed again a small recurrent lesion in the anterior commisure. Gamma knife therapy was used to successfully reduce the volume of the tumor. The MIB-1 labeling index (LI) of the specimen taken at the time of the first operation was at 9.2% and that of the second operation at 21.2%. Recently, the importance of MIB-1 LI for assessing proliferative activity of this tumor was reported. In patients whose MIB-1 LI is higher, they have more significant rate of recurrence. Our results also indicate that in cases where MIB-1 LI indicates a high value, careful follow-up is necessary. Through fact of the necessity of two operations and additional gamma knife therapy, we would like to stress the importance of MIB-1 LI in indicating the proliferative activity of this tumor. These surgical procedures are presented here, and the role of MIB-1 LI in determining the proliferative activity of craniopharyngioma is also discussed.
Anegawa
S
S
Department of Neurosurgery, Institute of Neurosciences, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka 830-0047, Japan.
Hayashi
T
T
Nakagawa
S
S
Furukawa
Y
Y
Tomokiyo
M
M
D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor / Q000032:analysis*; D002455:Cell Division; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology* / Q000601:surgery; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D019394:Ki-67 Antigen; D008279:Magnetic Resonance Imaging; D008297:Male; D009687:Nuclear Proteins / Q000032:analysis
D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009687:Nuclear Proteins