A Novel, Hybrid, Stereotactic Approach (Radiosurgery and Dual Ommaya Reservoirs) for the Treatment of Mixed (Polycystic and Solid) Craniopharyngioma - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Stereotactic and Functional Neurosurgery Année : 2019

A Novel, Hybrid, Stereotactic Approach (Radiosurgery and Dual Ommaya Reservoirs) for the Treatment of Mixed (Polycystic and Solid) Craniopharyngioma

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Résumé

Background: Craniopharyngioma is a difficult entity to treat, which is particularly true for mixed craniopharyngioma (i.e., a mixture of both solid and cystic components). The present case report illustrates a minimally invasive, two-component, stereotactic treatment approach as an alternative to standard microsurgery. Case Description: A 38-year-old patient presented with progressive intracranial hypertension followed by pan-hypopituitarism, deterioration of the visual field, and cognitive impairment. Brain MRI revealed hydrocephalus and a suprasellar mixed solid and polycystic lesion that was suggestive of craniopharyngioma. Using a robot-assisted, stereotactic treatment approach, we combined the installation of catheters for 2 Ommaya reservoirs with 5-fraction CyberKnife radiosurgery of the solid tumor. The high intracranial pressure and visual field deterioration resolved completely. A partial improvement in endocrine function was noted, and the patient returned to work 6 weeks after surgery. Conclusion: A combined, robot-assisted, stereotactic approach to the treatment of mixed (solid and polycystic) craniopharyngioma is a safe alternative to microsurgery. Further studies including larger numbers of patients will be needed to assess the long-term efficacy and morbidity and mortality rates associated with this approach.
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hal-03600325 , version 1 (07-03-2022)

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Meshal Jarebi, Alexandre Coutte, Florence Bartier, Yahya Khormi, Johann Peltier, et al.. A Novel, Hybrid, Stereotactic Approach (Radiosurgery and Dual Ommaya Reservoirs) for the Treatment of Mixed (Polycystic and Solid) Craniopharyngioma. Stereotactic and Functional Neurosurgery, 2019, 97 (4), pp.266-271. ⟨10.1159/000503690⟩. ⟨hal-03600325⟩

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