Radiological findings following postsurgical intratumoral bleomycin injection for cystic craniopharyngioma.
OBJECTIVE
The purpose of this study was to compare the radiological findings before and after intratumoral bleomycin injection in patients with cystic craniopharyngioma so as to define the role of adjuvant intracavitary bleomycin chemotherapy for cystic craniopharyngiomas.


METHODS
Eleven patients whose craniopharyngioma was confirmed cytologically and/or histologically were retrospectively reviewed. The follow-up duration ranged from 9 to 79 months (mean, 31.6 months). Only the solid portion of the cystic craniopharyngiomas was excised before repeated injections of bleomycin (15-180 mg in total) into the cystic portion through an Ommaya reservoir were given. The patients were evaluated neuroradiologically before and after bleomycin administration.


RESULTS
After the completion of all treatment cycles, the disappearance or shrinkage of the tumor was initially noted in all cases on follow-up CT and/or MR imaging studies. However, tumor recurrence was seen in four cases with a mixed tumor type.


CONCLUSIONS
Postoperative bleomycin injection in cystic craniopharyngioma does not appear to totally eradicate the tumor and does not stop tumor recurrence unless the cyst is the only portion of the craniopharyngioma that is left. Nevertheless, postoperative bleomycin injection decreases and stabilizes tumor size, and thus may be considered as an option of treatment modalities in patients with predominantly cystic craniopharyngiomas.
Kim
Sang-Dae
SD
Department of Neurosurgery, College of Medicine, Korea University, Seoul, Republic of Korea.
Park
Jung-Yul
JY
Park
Juno
J
Lee
Jang-Bo
JB
Kim
Se-Hoon
SH
Lim
Dong-Jun
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D003560:Cysts / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D011182:Postoperative Care; D014057:Tomography, X-Ray Computed
D000903:Antibiotics, Antineoplastic; D001761:Bleomycin