[Postoperative intracranial seeding of craniopharyngioma. Three case reports and a review of the literature].
Metastasis of craniopharyngioma is uncommon. Only 10 cases have been reported in the literature. In this report, we describe 3 patients who presented metastases following operative treatment of suprasellar craniopharyngioma. All 3 patients (ages: 32, 11, and 9 years) underwent radical excision of a supradiaphragmatic, retrochiasmatic craniopharyngioma by the right frontopterional approach. Resection was considered as total in all cases. All patients required hormone replacement therapy. Local recurrence was observed in only one case. Metastasis occurred along the surgical route in all three patients. The interval between surgery and metastasis was 5 and 3 years in the first two cases. The third patient presented two metastases: one in the temporal space at 3 years and another in the frontal space at 10 years. Repeat surgery was performed in 2 patients. The first case involved a lesion located in the right frontal space, and the second involved local recurrence and metastasis along the surgical route. The third patient was treated by puncture and radiation therapy for the temporal lesion and surveillance for the frontal lesions. No recurrence has been observed at 2 and 7 years after re-operation. Although rare, metastasis of craniopharyngioma has been reported up to 21 years after resection of the primary tumor. Metastasis often occurs along the surgical route, as in our 3 cases, but spreading to distant locations via cerebrospinal fluid has been observed. Regular follow-up is necessary, even after supposedly total resection.
Fuentes
S
S
Service de Neurochirurgie (Pr Grisoli), Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France. sfuentes@ap-hm.fr
Metellus
P
P
Dufour
H
H
Do
L
L
Grisoli
F
F
D000328:Adult; D001932:Brain Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002648:Child; D003397:Craniopharyngioma / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009366:Neoplasm Seeding; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D014057:Tomography, X-Ray Computed