Minimally Invasive Treatment of Posterior Fossa Craniopharyngioma by Means of Navigated Endoscopy

Abstract

The aim of the paper is to present an unusual case of ectopic posterior fossa craniopharyngioma after repeated surgeries for primary suprasellar tumor. The clinical condition of the patient favored minimally invasive neuroendoscopic surgery. After presurgical planning with the help of neuronavigation system a trajectory from the contralateral side through the cisterna magna was chosen. Endoscopic cyst fenestration and cyst wall resection were safely performed with an excellent outcome. The possible origin of this posterior fossa craniopharyngioma is discussed together with tumor dissemination pathways. The endoscopic contralateral approach to the tumor utilized the wide working space provided by the cisterna magna and the great versatility of the navigated neuroendoscopic approach was proven.

Key words

posterior fossa craniopharyngioma - neuronavigation - endoscopy

References

• 1 Zuccaro G. Radical resection of craniopharyngioma.  Childs Nerv Syst. 2005;  21 679-690
• 2 Kawamata T, Kubo O, Kamikawa S, Hori T. Ectopic clival craniopharyngioma.  Acta Neurochir (Wien). 2002;  144 1221-1224
• 3 Link MJ, Driscoll CL, Giannini C. Isolated, giant cerebellopontine angle craniopharyngioma in a patient with Gardner syndrome: case report.  Neurosurgery. 2002;  51 221-225
• 4 Bashir EM, Lewis PD, Edwards MR. Posterior fossa craniopharyngioma.  Br J Neurosurg. 1996;  10 613-616
• 5 Tomita S, Mendoza ND, Symon L. Recurrent craniopharyngioma in the posterior fossa.  Br J Neurosurg. 1992;  6 587-590
• 6 Ishii K, Sugita K, Kobayashi H, Kamida T, Fujiki M, Izumi T, Mori T. Intracranial ectopic recurrence of craniopharyngioma after Ommaya reservoir implantation.  Pediatr Neurosurg. 2004;  40 230-235
• 7 Nomura H, Kurimoto M, Nagai S, Hayashi N, Hirashima Y, Tsukamoto E, Endo S. Multiple intracranial seeding of craniopharyngioma after repeated surgery - case report.  Neurologia medico-chirurgica. 2002;  42 268-271
• 8 Novegno F, Rocco F di, Colosimo CJR, Lauriola L, Caldarelli M. Ectopic recurrencies of craniopharyngioma.  Childs Nerv System. 2002;  18 468-473
• 9 Lee DK, Jung HW, Kim DG, Paek SH, Gwak HS, Choe G. Postoperative spinal seeding of craniopharyngioma. Case report.  J Neurosurg. 2001;  94 617-620
• 10 Delitala A, Brunovi A, Chiapetta F. Purely neuroendoscopic transventricular management of cystic craniopharyngiomas.  Childs Nerv Syst. 2004;  20 558-562
• 11 Barajas MA, Ramírez-Guzmán G, Rodríguez-Vázguez C, Toledo-Buenrostro V, Vélasquez-Santana H, Valle del Nobles R, Cuevas-Solórzano, Rodríguez-Hernández G. Multimodal management of craniopharyngiomas: neuroendoscopy, microsurgery and radiosurgery.  J Neurosurg. 2002;  97 ((5 Suppl)) 607-609
• 12 Nicolato A, Foroni R, Rosta L, Gerosa M, Bricolo A. Multimodality stereotactic approach to the treatment of cystic craniopharyngiomas.  Minim Invas Neurosurg. 2004;  47 32-40
• 13 Novák Z, Chrastina J, Ríha I. Atlas of neuroendoscopic surgery.  Praha Maxdorf Jesenius. 2007; 

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