This large predominately cystic craniopharyngioma had previously been treated with surgery. Pituitary functions were normal. The marked diminution in size, as evidenced by the photographs, occurred as a consequence of radiotherapy. This patients case illustrates the fact that radiotherapy is an important adjunct to surgery in the management of predominantly cystic craniopharyngiomas. Some treating physicians recommend surgical decompression followed by installation of radioactive P 32. Others prefer conventional or gamma knife radiosurgery depending on the size of the target and proximity of adjacent structures. This particular patient was treated with conventional radiotherapy. As expected, he developed panhypopituitarism necessitating replacement therapy. Growth hormone replacement therapy is controversial in such patients. I do, however, treat patients with growth hormone if the disease process has been stable for one year or more.
Posted on: Tue, 20 Jan 2015 04:59:17 +0000
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