Delayed neurotoxic complication of intracavitary bleomycin therapy for craniopharyngioma in a child who had previously undergone radiosurgery. Case report.
Local administration of bleomycin for the treatment of craniopharyngioma is occasionally associated with serious regional complications. The authors report a case of a delayed neurotoxic complication associated with bleomycin treatment in a patient who had previously undergone radiosurgery. A 14-year-old boy presented with a cyst recurrence of mixed-type craniopharyngioma. An Ommaya device was placed in the thin-walled cyst, and after confirmation that the device was watertight, the patient received a total dose of 75 mg bleomycin intratumorally during a 5-week period. Six weeks after the final drug administration, the patient experienced complex partial epileptic seizures; a few days later sudden right temporal hemianopia developed. Within 5 days the patient became totally blind in his right eye, and the condition did not respond to corticosteroid therapy. Although drug-related toxic complications occur commonly during the course of intracavitary bleomycin treatment, they may also be encountered during the follow-up period. The reason for this delayed complication could have been previous radiotherapy or hypersensitivity of the tumor capsule to the drug.
Belen
Deniz
D
Department of Neurosurgery, Ministry of Health Diskapi Research and Educational Hospital, Ankara, Turkey. denizbelen2000@yahoo.com
Er
Uygur
U
Yigitkanli
Kazim
K
Bolay
Hayrunnisa
H
D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001929:Brain Edema / Q000139:chemically induced* / Q000175:diagnosis; D002408:Catheters, Indwelling; D003397:Craniopharyngioma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D015552:Injections, Intralesional; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed
D000903:Antibiotics, Antineoplastic; D001761:Bleomycin