97th DOG Annual Meeting 1999
STEREOTACTIC TREATMENT AND MICROSURGICAL REMOVEL OF CRANIOPHARYNGIOMA - A COMPARATIVE STUDY
R. Guthoff1, P. C. Warnke2, R. Unsöld3
Backround: Craniopharyngioma are rare benign neoplasm arising in and around the suprasellar area untreated causing damage to the optic nerve, chiasma, hypothalamus and pituitary. There is a current controversy about optimal management of craniopharyngioma because the efforts of the treatment are not only measured of mortality but also of morbidity.
Methods: We reviewed 21 patients with craniopharyngioma treated at the Albert-Ludwigs-Universität Freiburg from 1979 until 1994. We compared mortality and morbidity according to the neuroradiologic, ophthalmologic and endocrinologic data of patients. Eight patients underwent the stereotactic approach while 13 underwent both microsurgical and stereotactic procedures. Eleven patients received furthermore external beam irradiation.
Results: No death occurred in the stereotactic group within the median follow-up period of 77 month while one patient of the microsurgic-stereotactic treated group died of disease. In the stereotactic group tumour recurred in 3 cases whereas in the microsurgic-stereotactic group we found 100% of recurrences. There were no deterioration concerning the outcome of visual acuity, visual field and no case of new endocrinological failure in the stereotactic group. In contrast in the microsurgic-stereotactic treated group visual acuity worsened in 10 eyes (10 patients), visual field in 9 eyes (6 patients) and a new endocrinological deficiency was found in 11 patients.
Discussion: Although there has been no randomisation in this retrospective Study which limit the comparability of the results there is a tendency showing the superiority of stereotactic procedure in contrast to microsurgical treatment of craniopharyngioma.
1Augenklinik der Julius-Maximilians-Universität Würzburg, Josef-Schneider-Str. 11, D - 97080 Würzburg
2Abteilung Stereotaktische Neurochirurgie der Albert-Ludwigs-Universität Freiburg, Breisacher Str. 64, D - 79106 Freiburg
3ALP - Professor Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Blumenstr. 28, D - 20212 Düsseldorf, Germany