Park Dong Hyuk, Park Jung Yul, Kim Joo Han, Chung Yong Gu, Lee Hoon Kap, Lee Ki Chan, Suh Jung Keun
Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea.
J Korean Med Sci. 2002 Apr;17(2):254-9. doi: 10.3346/jkms.2002.17.2.254.
Total excision is a treatment of choice in preventing the relapse of craniopharyngioma, but for tumors involving an extensive area, it is often associated with an increased risk of complications. We have performed a partial or subtotal tumor removal followed by repeated injection of bleomycin into the remaining tumor through a subcutaneous reservoir as postoperative adjuvant therapy. A retrospective review of clinical, radiological, and surgical data was performed for 10 patients (5 males and 5 females; age, 3-65 yr; follow-up duration, 12-79 months) with cystic craniopharyngiomas. The measurements of lactate dehydrogenase (LDH) level at each aspiration were performed. The shrinkage and/or stabilization of tumor was initially noted in all cases. The recurrence of tumor was seen in 4 cases (40%). The decreased or increased level of LDH was interpreted as tumor shrinkage or recurrence, respectively. The transient toxic reactions were observed in 3 patients (30%). Our study demonstrates that postoperative bleo-mycin injection for cystic craniopharyngioma, although does not appear to eradicate the tumor, decreases and stabilizes the tumor size, when used as an adjuvant therapy in young patients.
全切除是预防颅咽管瘤复发的首选治疗方法，但对于累及范围广泛的肿瘤，全切除常伴有并发症风险增加。我们采用了部分或次全肿瘤切除，随后通过皮下储液器向残留肿瘤反复注射博来霉素作为术后辅助治疗。对10例囊性颅咽管瘤患者（5例男性，5例女性；年龄3 - 65岁；随访时间12 - 79个月）的临床、影像学和手术数据进行了回顾性分析。每次抽吸时均测量乳酸脱氢酶（LDH）水平。所有病例最初均观察到肿瘤缩小和/或稳定。4例（40%）出现肿瘤复发。LDH水平降低或升高分别被解释为肿瘤缩小或复发。3例患者（30%）观察到短暂的毒性反应。我们的研究表明，对于囊性颅咽管瘤，术后注射博来霉素虽然似乎不能根除肿瘤，但在年轻患者中作为辅助治疗使用时，可减小肿瘤大小并使其稳定。
