Craniopharyngiomas are benign tumours that show a bimodal age distribution and arise in two distinct clinicopathological variants: the adamantinomatous and the papillary subtypes.1 The molecular mechanisms involved in craniopharyngiomas remain elusive. While a genetic susceptibility is not known, there are reports describing the occurrence of craniopharyngiomas in consanguineous siblings2 as well as in a mother and daughter.3 To date, cytogenetic (that is, karyotypic) data on only 11 craniopharyngiomas have been published,5-,8 and have shown multiple chromosomal abnormalities in two cases, both of which involved chromosomes 2 and 12,5,7 while the other nine cases presented with normal karyotypes6,8; four additional craniopharyngiomas showed no mutations of the TP53 tumour suppressor gene.9 In view of the association of naevoid basal cell carcinoma or Gorlin syndrome with the occurrence of craniopharyngiomas, a recent study was carried out on 22 adamantinomatous craniopharyngiomas. This found no ...
PRIMARY OBJECTIVES:. I. To determine the activity of BRAF and MEK inhibitor combination in untreated papillary craniopharyngiomas as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.. II. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas that have progressed after prior radiation treatment with or without surgical resection as measured by best response at any time during the first four cycles of BRAF and MEK inhibitor treatment.. SECONDARY OBJECTIVES:. I. To determine the progression-free survival of patients with papillary craniopharyngiomas receiving BRAF and MEK inhibitors.. II. To determine the toxicity of BRAF/MEK inhibitors in patients with papillary craniopharyngiomas.. III. To determine the activity of BRAF and MEK inhibitor combination in papillary craniopharyngiomas as measured by response of enhancing volume of craniopharyngioma.. IV. To determine the activity of BRAF and MEK inhibitor ...
Craniopharyngiomas (CP) are rare epithelial tumors of the sellar region. Two subtypes, adamantinomatous (adaCP) and papillary CP (papCP), were previously identified based on histomorphological and epidemiological aspects. Recent data indicates that both variants are defined by specific genetic alterations, and influenced by distinct molecular pathways and particular origins. The fact that CP is an uncommon tumor entity renders studies on large cohorts difficult and exceptional. In order to achieve further insights distinguishing CP variants, we conducted whole genome methylation (450 k array) and microarray-based gene expression studies in addition to CTNNB1 and BRAF mutation analysis using a comprehensive cohort of 80 adaCP and 35 papCP. BRAF V600E mutations were solely found in the papCP subgroup and were not detectable in adaCP samples. In contrast, CTNNB1 mutations were exclusively detected in adaCP. The methylome fingerprints assigned DNA
TY - JOUR. T1 - Proliferative activity in craniopharyngiomas. T2 - Clinicopathological correlations in adults and children. AU - Raghavan, Ravi. AU - Dickey, William T.. AU - Margraf, Linda R.. AU - White, Charles L.. AU - Coimbra, Caetano. AU - Hynan, Linda S.. AU - Rushing, Elisabeth J.. PY - 2000. Y1 - 2000. N2 - BACKGROUND: Craniopharyngiomas are slow-growing, locally invasive intracranial tumors that can generate considerable morbidity, and recurrences are often difficult to manage. Because reliable morphologic criteria for accurately predicting the clinical outcome of these tumors are lacking, we evaluated the growth potential of craniopharyngiomas by measuring their proliferative activity based on MIB-1 immunostaining for the Ki-67 antigen, which is expressed during all phases of the cell cycle except G0. METHODS: Paraffin sections from 37 cases of craniopharyngiomas were immunostained with the monoclonal antibody MIB-1, and a labeling index was derived in each case from an the with the ...
AbstractIntroduction: Craniopharyngioma of childhood are commonly cystic in nature. An intracystic catheter insertion and subsequent instillation of substances inducing cyst shrinkage seems a beneficial strategy avoiding additional morbidity in a highly vulnerable brain location. Methods: A systematic review of the medical literature was performed to identify potentially relevant, all languages articles using Ovid MEDLINE and EMBASE from inception to July 2011 and Cochrane Central Register of Controlled Trials to 3rd quarter 2011. All references were examined for relevancy. Results: Of 142 unique references x referred to substances used for intracystic craniopharyngioma treatment. General aspects of intracystic catheter insertion as well as response rates, risks and outcomes of children treated with intracystic radio-isotopes, bleomycin and interferon are critically reviewed and an outline for potential future endeavours provided. Conclusions: Interferon seems currently the intracystic substance with
... (Erdheim tumor) is a rare, benign neoplasm, that develops from epithelium derived from Rathkes pouch and usually affects children.… Craniopharyngioma (Craniopharyngiomas): Read more about Symptoms, Diagnosis, Treatment, Complications, Causes and Prognosis.
Genes involved in formation/development of the adenohypophysis, CTNNB1 gene, and microRNAs might be implicated in the craniopharyngioma pathogenesis. The objective of this study is to perform the molecular analysis of HESX1, PROP1, POU1F1, and CTNNB1 genes and evaluate a panel of miRNA expression in craniopharyngioma. We also verified whether the presence of CTNNB1 mutation is associated with clinical findings and miRNA expression. The study included 16 patients with adamantinomatous craniopharyngioma (nine children and seven adults; eight females and eight males; 6-55 years, median 15.5 years). DNA, RNA, and cDNA were obtained from craniopharyngioma and normal pituitaries. DNA was also extracted from peripheral blood of healthy subjects. All genes were amplified by polymerase chain reaction and direct sequenced. Relative quantification of miRNA expression was calculated using the 2(-ΔΔCt) method. We found no mutations in HESX1, PROP1, and POU1F1 genes and four polymorphisms in PROP1 gene ...
Craniopharyngiomas are benign epithelial tumors of the sellar region but can have significant neurological and endocrinological consequences and may require treatment that will cause further morbidity. The first description of a craniopharyngioma is credited to Zenker, who made this observation in 1857.
Craniopharyngiomas have always been an extremely challenging type of tumor to treat. The transsphenoidal route has been used for resection of these lesions since its introduction. The authors present a historical review of the literature from the introduction of the endonasal route for resection of craniopharyngiomas until the present. Abandoned early due to technological limitations, this approach has been expanded both in its application and in its anatomical boundaries with subsequent progressive improvements in outcomes. This expansion has coincided with advances in visualization devices, imaging guidance techniques, and anatomical understanding. The progression from the use of headlights, to microscopy, to endoscopy and fluoroscopy, and finally to modern intraoperative magnetic resonance-guided techniques, combined with collaboration between otolaryngologists and neurosurgeons, has provided the framework for the development of current techniques for the resection of sellar and suprasellar ...
Craniopharyngiomas (see the image below) are histologically benign neuroepithelial tumors of the CNS that are predominately observed in children aged 5-10 years.{file44804}These tumors arise from squamous cell embryologic rests found along the path of the primitive adenohypophysis and craniopharyngeal duct.
Surgery with cyst drainage. Surgery may be done to drain tumors that are mostly fluid-filled cysts. This lowers pressure in the brain and relieves symptoms. A catheter (thin tube) is inserted into the cyst and a small container is placed under the skin. The fluid drains into the container and is later removed. Sometimes, after the cyst is drained, a drug is put through the catheter into the cyst. This causes the inside wall of the cyst to scar and stops the cyst from making fluid or increases the amount of the time it takes for the fluid to build up again. Surgery to remove the tumor may be done after the cyst is drained.. Chemotherapy. Chemotherapy is a treatment that uses anticancer drugs to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach tumor cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly ...
Since a craniopharyngioma grows near the pituitary gland, symptoms are caused by the pressure the growing tumor puts on that glad as well as on nearby structures. The symptoms depend on what structure is being compressed:
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A collection of disease information resources and questions answered by our Genetic and Rare Diseases Information Specialists for Craniopharyngioma
Charles H. Frazier (1870-1936), one of the pioneers of neurosurgery in the US, is known worldwide for devising surgical procedures to relieve trigeminal neuralgia and intractable pain. Less well-known are his substantial contributions to understanding and treating pituitary and parahypophyseal lesions. Along with Bernard Alpers, he defined Rathkes cleft tumors as a different pathological entity from adenomas and hypophyseal stalk tumors (craniopharyngiomas [CPs]). The surgical challenge posed by CPs piqued Fraziers interest in these lesions, although he never published a complete account of his CP series. An examination of the Charles Frazier papers at the College of Physicians of Philadelphia allowed the authors to identify 54 CPs that he had treated during his career. In the early 1910s, Frazier developed the subfrontal approach, which would become the primary surgical route to access these lesions, providing better control of the adjacent vital neurovascular structures than the ...
Purpose of this study is to investigate whether intraoperative imaging using a 1.5T MRI in craniopharyngioma surgery is useful in order to increase the
We identified 24 previously reported cases in addition to our three cases. Mean age was 36.6 years (range 5-68). There were 16 (59%) females. The most common (74%) presenting symptom was endocrinological deficits, typically either isolated diabetes insipidus (DI) or panhypopituitarism. Location was intrasellar in 3 (11%), suprasellar in 6 (22%), and intrasellar/suprasellar in 18 (67%) patients. Lesions were most commonly (83%) T1 hyperintense. Gross total resection was achieved in 16 (64%) and subtotal resection in 9 (36%) patients. Of the seventeen (63%) patients presenting with varying degrees of bitemporal hemianopsia, all had improvement in vision postoperatively. It is worth noting that no cases of preoperative hypopituitarism or DI improved postoperatively. Even though gross total resection was only achieved in 64%, there was only one recurrence reported. ...
Individuals with adult-onset craniopharyngioma reported postoperative quality of life measures that were comparable with those of other primary and secondary brain tumors, despite the benign biology of the condition, according to an analysis of German registry data published in The Journal of Clinical Endocrinology & Metabolism. “Adult craniopharyngioma, contrary to child-onset
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Bilateral subfrontal gives much better access than unilateral. The blind spot behind ipsilateral optic nerve can be visualised from the contralateral side. I never use unilateral approach. Head extended so that frontal lobes fall back by gravity. Do not use lumbar drain because much higher chance of extradural hematoma because frontal lobe often sunken at the end of surgery with drainage of CSF.. Bicoronal curvy incision results in better hair growth than straight one. Skin incision does not need to go all the way down to zygomatic arches unless pterygonal approach is needed as well. In that case head is tilted slightly toward that side. Harvest pericranium for repair using wet gauze to wipe the pericranium off the bone. Temporalis fascia may be harvested toward end of operation if needed for dural repair. Burr holes are made either above lateral orbital rim or behind depending on the amount of exposure needed. Use a long cutting blade to reach near midline and crack the middle.. Alternatively, ...
Radiation therapy is commonly used to treat a variety of brain tumors in children including ependymoma, craniopharyngioma and low- and high-grade glioma. The ability of the therapy to control brain tumors in children is known to depend on the tumor type, extent of resection and other clinical factors. Children who received radiation therapy on this study were evaluated for treatment failure at 12 months. In addition to the primary objective, the study was designed to explore the association between radiation dose and volume and a variety of neurological, endocrine and cognitive deficits up to 5 years after treatment ...
Story told by Jenny Shapiro- Mother of Alexis When Alexis was diagnosed with a brain tumor, I had never imagined what this would mean for our family long-term. The type of brain tumor she had is called Craniopharyngioma; which is a rare tumor found near the pituitary gland.. Although the surgery to remove the tumor a few years ago was a success; it in turn damaged Alexiss hypothalamus and pituitary gland, which are two organs that help regulate energy balance, appetite, and weight. My daughters adrenal insufficiency leaves her vulnerable to potentially lethal blackouts.. As we were leaving the hospital after her surgery, the doctor explained to us the extreme importance of carrying an emergency needle and vial of a special steroid called Solu- Cortef, which must be injected within minutes after feeling any symptoms. Without this hormone in her body; my daughter could easily become unresponsive very quickly, or even comatose.. This was profoundly frightening to me as a mother. I reached the ...
h2,How is a craniopharyngioma treated?,/h2,,h3,Surgery when the tumour is mostly solid,/h3,,p,One approach to treatment is to remove as much of the tumour as possible using surgery. This can be difficult because these tumours "stick" to nearby tissues. ,/p,,p,If only part of the tumour is removed in surgery, then radiation therapy may be used to treat the remaining tumour. Radiation involves the use of high-energy X-rays, gamma rays, or electrons to destroy tumour cells. ,/p,,p,Before the main operation to remove the tumour, the surgeon may need to do a smaller operation. If one of the cysts is pressing against an important part of the brain and causing an increase in pressure, the surgeon may decide to drain the fluid in the cyst. He will make a small hole (burr hole) in the skull and insert a tube into the cyst to drain it or he may put a permanent shunt in called an Ommaya reservoir. ,/p,,h3,Surgery when the tumour is mostly cystic,/h3,,p,If one of the cysts is pressing against an important ...
Shannon was diagnosed with a rare craniopharyngioma brain tumour when she was just nine-years-old. She underwent emergency surgery and has endured several operations over the years, plus treatment including radiotherapy and hormone replacement. Now 18, and a college student, she is certified blind and relies on a long cane to help her get about. She is looking forward to leaving home and studying at university.
Im the mom of Summer, who was diagnosed with a rare brain tumor called Craniopharyngioma on 4/29/2010 at 19 months old. She had two craniotomies before turning two, and started chemical therapy a few days after her 2nd birthday. Summer finished proton radiation in Boston at the end of February 2011, and now were in wait and see what happens mode! Here I blog about her treatment and progress as a way to keep family and friends up-to-date ...
Im the mom of Summer, who was diagnosed with a rare brain tumor called Craniopharyngioma on 4/29/2010 at 19 months old. She had two craniotomies before turning two, and started chemical therapy a few days after her 2nd birthday. Summer finished proton radiation in Boston at the end of February 2011, and now were in wait and see what happens mode! Here I blog about her treatment and progress as a way to keep family and friends up-to-date ...
Craniopharyngioma is a common tumor in childhood, but can also be seen in adults. These tumors often present with endocrine problems, abnormalities of appetite, visual problems. MRI gives diagnosis and treatment involves surgery. Attempt must be made at complete excision, with safeguarding of vital hypothalamic functions. Radiation may be required after surgery to halt tumor followed by surgical excision, with excellent results.. ...
Preoperative plain (a-f) and contrast (g-i)-computed tomography scan showing craniopharyngioma with calcification (arrow down) extending up to right side forame
Ashley Age 9 Craniopharyngioma Favorite character: Tigger and Pooh, because theyre funny Favorite Bert Show member: Bert, because hes funny! Favorite
At the European Molecular Biology Laboratory (EMBL) in Heidelberg, Professor Parton was mentored by Gareth Griffiths, where he honed his skills in electron microscopy while collaborating with other groups throughout the institute including Jean Gruenberg and Marino Zerial. He has maintained these collaborations to this day, despite the groups now being spread around the globe.. Collaboration has been central to his career. In a collaborative project with the laboratory of Kai Simons, he observed that the newly-discovered protein, VIP21 (later renamed caveolin-1), was an abundant marker protein of caveolae. Also at the EMBL Parton and Michael Way discovered a second member of the caveolin family, M-caveolin, now termed caveolin-3.. At The University of Queensland he collaborated with Professor John Hancock. Together they showed that caveolin mutants can act as dominant negative inhibitory mutants and that one of the mutants was a highly potent inhibitor of Ras signalling. Inhibition was specific ...
TY - JOUR. T1 - Stereotactic radiosurgery of residual or recurrent craniopharyngioma. T2 - New treatment concept using leksell gamma knife model C with automatic positioning system. AU - Yomo, Shoji. AU - Hayashi, Motohiro. AU - Chernov, Mikhail. AU - Tamura, Noriko. AU - Izawa, Masahiro. AU - Okada, Yoshikazu. AU - Hori, Tomokatsu. AU - Iseki, Hiroshi. PY - 2009/11/1. Y1 - 2009/11/1. N2 - Background/Aims: The present study analyzed the initial experience with the application of the original concept of robotic microradiosurgery using Leksell Gamma Knife Model C with automatic positioning system for management of craniopharyngiomas. Methods: Eighteen patients with residual or recurrent craniopharyngiomas underwent radiosurgery with the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. Treatment ...
Thirst is stimulated by increases in effective plasma osmolality that are detected by cerebral osmoreceptors located in the vascular organ of the lamina terminalis. However, surgical destruction or organic lesions of the lamina terminalis decrease the sensation of thirst in response to increased plasma osmolality. A 17-year-old boy who was diagnosed with craniopharyngioma at the age of 10 years and underwent tumor resection and gamma knife surgery was admitted for non-symptomatic severe hypernatremia. Although the sodium level was 173 mmol/L and serum osmolality was also high (371 mOsm/kg), the patient did not report increased thirst. Laboratory analysis revealed hypertonic dehydration and acute non-oliguric renal failure due to dehydration. Treatment was based on correction of hypernatremia with hydration and education about regular, periodic water ingestion. The patients hypernatremia and acute non-oliguric renal failure resolved with controlled daily fluid intake. To our knowledge, this is ...
This patient presented with hyperprolactinemia. MRI reveals T1/T2 hyperintense lesion in the left posterior aspect of the pituitary with convex superior margin with minimal enhancement on post contrast scans. The pituitary stalk is deviated to right. Fluid level is noted in the axial section. The optic chiasm & cavernous sinus appears normal. No parasellar abnormality. Differentials include first differential of rathkes cleft cyst versus other possibility of cystic adenoma. Rathkes cleft cysts are nonneoplastic, sellar or suprasellar epithelium-lined cysts arising from the embryologic remnants of Rathkes pouch in the pituitary gland. Hyperprolactinemia in Rathke cleft cyst is due infundibular stalk compression. ...
A Rathkes cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathkes pouch does not develop properly and ranges in size from 2 to 40mm in diameter. Asymptomatic cysts are commonly detected during autopsies in 2 to 26 percent of individuals who have died of unrelated causes. Females are twice as likely as males to develop a cyst. If a cyst adds pressure to the optic chiasm, it may cause visual disturbances, pituitary dysfunction, and headaches. The majority of pituitary patients with chronic headaches have Rathkes Cleft Cysts. This is believed to be caused by the constant change in volume and the drastic changes in vasopressure from fluctuations in gonadotrophs and ADH. The treatment of choice for symptomatic cysts is drainage and taking a biopsy. Radical excision is more dangerous because of the potential of damaging the patients pituitary function e.g. ADH ...
In embryogenesis, Rathkes pouch is an evagination at the roof of the developing mouth in front of the buccopharyngeal membrane. It gives rise to the anterior pituitary (adenohypophysis), a part of the endocrine system. Rathkes pouch, and therefore the anterior pituitary, is derived from ectoderm. The pouch eventually loses its connection with the pharynx giving rise to the anterior pituitary. The anterior wall of Rathkes pouch proliferates, filling most of the pouch to form pars distalis and pars tuberalis. The posterior wall forms pars intermedia. In some organisms, the proliferating anterior wall does not fully occupy Rathkes pouch, leaving a remnant (Rathkes cleft) between the pars distalis and pars intermedia. Rathkes pouch may develop benign cysts. Craniopharyngioma is a neoplasm which can arise from the epithelium within the cleft. It is named for Martin Rathke. Rathkes cleft cyst synd/3564 at Who Named It? M. H. Rathke. Entwicklungsgeschichte der Natter (Coluber natrix). ...
Ophthalmologists are often the first port of consultation and patients may present with headache, unilateral or bilateral visual loss, visual field loss, hemislide phenomenon, post fixational blindness, see-saw nystagmus, cranial nerve palsy, papilledema, and bow tie optic atrophy. Besides causing the chiasmal syndrome most commonly, craniopharyngioma has infrequently been reported to cause junctional scotoma, paracentral bitemporal hemianopia(anterior or posterior optic chiasma syndrome) or homonymous hemianopia (optic tract syndrome). However because of the suprachiasmatic location of the tumour there is a clear association between inferior visual field defects and craniopharyngioma, but in clinical practice most patients do not present with inferior field loss (as in our patient) (4). Pleomorphism- distinct change from one type of field defect into another type of visual field defect- is characteristic of craniopharyngioma. It is related to intermittent emptying of cyst fluid into ventricular ...
The craniopharyngiomas are solid cystic suprasellar tumors that can present extension to adjacent structures, conditioning pituitary and hypothalamic dysfunction. Within hypothalamic neuroendocrine dysfunction, we can find obesity, behavioral changes, disturbed circadian rhythm and sleep irregularities, imbalances in the regulation of body temperature, thirst, heart rate and/or blood pressure and alterations in dietary intake (like anorexia). We present a rare case of anorexia-cachexia syndrome like a manifestation of neuroendocrine dysfunction in a patient with a papillary craniopharyngioma. Anorexia-cachexia syndrome is a complex metabolic process associated with underlying illness and characterized by loss of muscle with or without loss of fat mass and can occur in a number of diseases like cancer neoplasm, non-cancer neoplasm, chronic disease or immunodeficiency states like HIV/AIDS. The role of cytokines and anorexigenic and orexigenic peptides are important in the etiology. The ...
J Neurosurg 124:627-638, 2016. Craniopharyngiomas and similar midline suprasellar tumors have traditionally been resected via transcranial approaches. More recently, expanded endoscopic endonasal transsphenoidal approaches have gained interest. Surgeons have advocated for both approaches, and at present there is no consensus whether one approach is superior to the other. The authors therefore compared surgical outcomes between craniotomy and endoscopic endonasal transsphenoidal surgery (EETS) for suprasellar tumors treated at their institution.. Methods: A retrospective review of patients undergoing resection of suprasellar lesions at Cedars-Sinai Medical Center between 2000 and 2013 was performed. Patients harboring suspected craniopharyngioma were selected for extensive review. Other pathologies or predominantly intrasellar masses were excluded. Cases were separated into 2 groups, based on the surgical approach taken. One group underwent EETS and the other cohort underwent craniotomy. Patient ...
J Neurosurg 124:627-638, 2016. Craniopharyngiomas and similar midline suprasellar tumors have traditionally been resected via transcranial approaches. More recently, expanded endoscopic endonasal transsphenoidal approaches have gained interest. Surgeons have advocated for both approaches, and at present there is no consensus whether one approach is superior to the other. The authors therefore compared surgical outcomes between craniotomy and endoscopic endonasal transsphenoidal surgery (EETS) for suprasellar tumors treated at their institution.. Methods: A retrospective review of patients undergoing resection of suprasellar lesions at Cedars-Sinai Medical Center between 2000 and 2013 was performed. Patients harboring suspected craniopharyngioma were selected for extensive review. Other pathologies or predominantly intrasellar masses were excluded. Cases were separated into 2 groups, based on the surgical approach taken. One group underwent EETS and the other cohort underwent craniotomy. Patient ...
Objective Rathkes cleft cysts (RCCs) are quite uncommon sellar lesions that can extend or even arise in the suprasellar area. The purpose of this study is to evaluate the effectiveness of both standard and extended endoscopic endonasal approaches in the management of different located RCCs. Methods We retrospectively analyzed a series of 29 patients (9 males, 20 females) complaining of a RCC, who underwent a standard or an extended endoscopic transsphenoidal approach at the Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, of the Università degli Studi di Napoli Federico II
Contributors. 1 Introduction (Edward J. Estlin, Richard J. Gilbertson and Robert F. Wynn).. Part I Central Nervous System Tumors of Childhood.. 2 Low- and High-Grade Glioma (Ian F. Pollack).. 3 Ependymoma (Thomas E. Merchant and Richard J. Gilbertson).. 4 Embryonal Tumors (Amar Gajjar and Steven C. Clifford).. 5 Pediatric Spinal Cord Tumors (Annie Huang, Ute Bartels and Eric Bouffet).. 6 Pediatric Craniopharyngioma, Mixed Glioneuronal Tumors, and Atypical Teratoid/Rhabdoid Tumor (Adrienne Weeks and Michael D. Taylor).. Part II Hematological Disorders.. 7 Acute Lymphoblastic Leukemia (Robert F. Wynn).. 8 Acute Myeloid Leukemia and Myelodysplastic Disorders (David K.H. Webb).. 9 Non-Hodgkins Lymphoma (Angelo Rosolen and Lara Mussolin).. 10 Hodgkins Lymphoma (Wolfgang Dörffel and Dieter Körholz).. 11 Histiocytic Disorders (Sheila Weitzman and R. Maarten Egeler).. Part III Solid Tumors of Childhood.. 12 Neuroblastoma (Sucheta J. Vaidya and Andrew D. J. Pearson).. 13 Renal Tumors (Edward J. ...
Objective: The presented single-centre study summarizes the outcome after intracavitary brachytherapy (IBT) using stereotactically applied phosphorus-32 (32P) colloid for the treatment of cystic craniopharyngiomas. We assessed its efficacy and safety, based on tumor control and endocrinological, ophthalmological, and neurological outcomes in one of the largest reported patient series.. Methods: Between April 1992 and January 2011, 53 patients (including 19 children aged , 20 y) with 56 cysts were treated with IBT-14 had no prior treatment and 39 had been treated for recurrent cysts. The intervention was performed by applying 200 Gy (median, range: 200-250 Gy) to the internal cyst wall (median volume 6.1 ml). The median clinical and radiological follow-up was 60.2 and 53.0 months, respectively.. Results: The actuarial tumor cyst control rate was 86.0 5.3% at 12, 24, and 60 months. The development of new cysts or progression of solid tumor parts (out-of-field progression) occurred in 18 patients ...
... Prolactinoma, Craniopharyngioma, Rathkes cleft cyst, Transnasal Transsphenoidal endoscopic pituitary surgery, technique of removal of tumour through the nose, Sellar and Parasellar tumors, Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.
Cystic sellar lesions are a rare cause of hypopituitarism and extremely rare in the pediatric age group. The differential diagnosis is large and includes both primary pituitary abscesses and cystic components on pre-existing lesions, such as adenoma, craniopharyngioma, Rathkes cleft cyst, leukemia, granulomatous disease and lymphocytic hypophysitis. In the absence of a definitive diagnosis, treatment can be challenging. We report a case of a 15-year-old female, who presented with headaches, altered consciousness and diplopia after a molar extraction, for which she had received oral antibiotics. Broad-spectrum i.v. antibiotics were given for presumed meningitis. Blood cultures failed to identify pathogens. Cerebral magnetic resonance imaging showed a pituitary cystic lesion. Endocrine studies revealed abnormal pituitary function. In the absence of a therapeutic response, the patient underwent a transsphenoidal biopsy of the pituitary gland, which yielded a purulent liquid, but cultures were ...
Appearances are unaltered. A cystic lesion mostly fills the pituitary fossa and bulges into the suprasellar cistern and not compressing or distorting the optic chiasm. It measures 17 x 10 by 11 mm, unaltered when compared to previous imaging, it continues to have a T1 hyper intensity and T2 hypointense (previous imaging) nodule posteroinferiorly within the cyst, which does not enhance. The remainder of the imaged brain (please note this study has been targeted to the pituitary, and as such the whole brain has not been imaged) appears unremarkable.. Conclusion:. Stable appearances when compared to previous imaging, and remain most consistent with a Rathkes cleft cyst. Particularly the luminal nodule, although unusually large, is quite characteristic. ...
In Females: HMG is used in a sequential manner in conjunction with HCG for the induction of ovulation and pregnancy in the anovulatory infertile patient in whom the cause of anovulation is functional (secondary to pituitary insufficiency) and is not due to primary ovarian failure. HMG and HCG may also be used to stimulate the development of multiple follicles in ovulatory patients participating in an in-vitro fertilization program. In Males: HMG is used in conjunction with HCG to stimulate spermatogenesis in primary hypogonadotropic hypogonadism (resulting from hypophysectomy, craniopharyngioma, cerebral aneurysm or chromophobe adenoma ...