[Treatment of craniopharyngiomas in children].
OBJECTIVE
The purpose of this article is to assess, in a 25-year retrospective study, the clinical outcome in children with craniopharyngioma.


METHODS
From 1978 to 2002, 12 children younger than 15-year-old underwent treatment with surgery and/or radiotherapy for craniopharyngioma. The clinical course and outcome were reviewed.


RESULTS
The median age was 7.3 years (range, 3 to 12 years) at the time of initial surgical resection. With a mean follow-up period of 132 months (range, 29 to 255 months), 1 patient died of tumor progression due to malignant transformation at 205 months after the initial surgery and the overall outcome was good in 11 patients. Out of 12 patients 4 presented a recurrence of their tumor, 2 after an apparently gross total removal. Because of tumor recurrence, 2 received conventional radiation therapy and 3 received gamma knife radiosurgery. There was neither operative mortality nor major complication. All patients required hormonal replacement postoperatively.


CONCLUSIONS
The goal in the treatment of craniopharyngiomas is to achieve total removal without morbidity. Our results compared favorably with the previous reports in the literature. MRI follow-up should be performed even in patients whose primary tumor is resected "completely". Suitable combination of open surgery, conventional radiotherapy and gamma knife radiosurgery may result in optimal functional outcome. Recovery from postoperative pituitary dysfunction can be occasionally expected.
Sakai
Keiichi
K
Department of Neurosurgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621 Japan. skeiichi@hsp.md.shinshu-u.ac.jp
Tanaka
Yuichiro
Y
Hongo
Kazuhiro
K
Tada
Tsuyoshi
T
Shigeta
Hiroaki
H
Kobayashi
Shigeaki
S
D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome