Cystic craniopharyngioma: trans-sphenoidal surgery and intra-cystic apposition of "bleomycin wax".
BACKGROUND
The current therapeutic approach to craniopharyngioma is multidisciplinary. Sub-total removal, followed by adjuvant treatments, especially in large cystic tumours, is an accepted regime reported by many authors.


METHODS
A young patient with an intra- and suprasellar cystic craniopharyngioma was operated on via a microsurgical trans-sphenoidal approach, achieving sub-total removal and bleomycin mixed with bone wax ("bleomycin wax") applied to the capsular remnant.


RESULTS
Pre-operative neurological and endocrinological deficit improved after surgery. There was no evidence of tumour recurrence after a follow-up period of 5.4 years.


CONCLUSIONS
The intra-operative use of "bleomycin-wax" should be limited to those patients in whom intra-operative CSF fistula does not occur.
Fraioli
Mario Francesco
MF
Department of Neurosciences, Neurosurgery, University of Rome Tor Vergata, Rome. Italy, b.fraioli@libero.it
Moschettoni
Laura
L
Catena
Elisabetta
E
Fraioli
Chiara
C
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001761:Bleomycin / Q000008:administration & dosage*; D002648:Child; D003397:Craniopharyngioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003560:Cysts / Q000188:drug therapy / Q000473:pathology; D003919:Diabetes Insipidus / Q000188:drug therapy / Q000209:etiology; D004338:Drug Combinations; D004847:Epithelial Cells / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery; D019635:Neurosurgical Procedures; D009897:Optic Chiasm / Q000473:pathology / Q000601:surgery; D010168:Palmitates / Q000008:administration & dosage; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014885:Waxes
D000903:Antibiotics, Antineoplastic; D004338:Drug Combinations; D010168:Palmitates; D014885:Waxes; D001761:Bleomycin; C055480:bone wax