"Conservative" surgical approach and early postoperative radiotherapy in a patient with a huge cystic craniopharyngioma.
OBJECTIVE
The treatment of huge craniopharyngiomas represents a therapeutic challenge for neurosurgeons. Some authors prefer to run the high risks of total removal at primary surgery, while others do not despise subtotal removal in accordance with a multidisciplinary treatment.


METHODS
We report the case of a 17-year-old girl who underwent subtotal removal (tumour remnant with maximum diameter of 2.5 cm) of a huge cystic craniopharyngioma by frontotemporal approach, followed by early external fractionated radiotherapy by linear accelerator. Serial magnetic resonance imaging during a follow-up period of 5 years showed a progressive marked reduction of the tumour remnant, accompanied by a complete recovery of visual deficits and an almost complete regression of diencephalic disturbances.


CONCLUSIONS
Subtotal removal followed by early fractionated radiotherapy can be an effective treatment for huge craniopharyngiomas. Such a multidisciplinary treatment may favour tumour control and assure a satisfactory quality of life as well.
Fraioli
Mario Francesco
MF
Department of Neurosciences, Neurosurgery, Tor Vergata University of Rome, Via Oxford 81, 00133, Rome, Italy. b.fraioli@libero.it
Santoni
Riccardo
R
Fraioli
Chiara
C
Contratti
Filiberto
F
D000293:Adolescent; D003397:Craniopharyngioma / Q000628:therapy*; D005260:Female; D006801:Humans; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging / Q000379:methods; D010911:Pituitary Neoplasms / Q000628:therapy*; D011184:Postoperative Period; D011878:Radiotherapy / Q000379:methods*