Repeated neuroendoscopic palliative surgery in elderly patients with predominantly cystic craniopharyngioma in the third ventricle: three case reports

Abstract

Objective: The management of craniopharyngioma in the elderly remains controversial. We sought to better characterize the outcomes of elderly patients treated with neuroendoscopic palliative surgery (NPS). Methods:We report the cases of three patients older than 80 years, whose cystic craniopharyngioma was treated by repeated NPS. Results: One male and two female patients, ranging in age from 80 to 83 years (mean = 81.3 years) had predominantly cystic lesions in the third ventricle and a suprasellar enhanced mass. Two patients underwent two NPS procedures and the other received three. The operating time ranged from 40 to 140 min (mean = 93.4 min), and the interval between operations ranged from 2 to 24 months (mean = 11.3 months). The length of postoperative hospitalization ranged from 4 to 28 days (mean = 11.1 days). There were no perioperative complications, and all patients experienced symptom improvement immediately after the operation. Conclusion: Repeated NPS can be an effective alternative treatment for cystic craniopharyngioma in the third ventricle, especially in elderly patients.

Transventricular Endoscopic Approach for Cystic Craniopharyngioma: Case Series

“…In our series there were fewer recurrences hence we could not compute the predictors of recurrence. The recurrences have been treated with microsurgical resection with either transcallosal or transsphenoidal approach, 29 30 repeat endoscopic procedure, 21 or aspiration through the reservoir. In our series out of eight cases of recurrence, five could be managed with only aspiration, two required microsurgical resection, and one required only a VP shunt for hydrocephalus.…”

“…Later many case series and reports of transventricular endoscopy for treatment of craniopharyngioma were reported. 4 5 7 9 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33…”

“…Later many case series and reports of transventricular endoscopy for treatment of craniopharyngioma were reported. 4,5,[17][18][19][20][21][22][23][24][25]7,9,[11][12][13][14][15][16][26][27][28][29][30]31,32,33 Indication of transventricular endoscopic approach An ideal indication would be a purely or predominantly cystic craniopharyngioma arising within or extending inside the third ventricle causing obstructive hydrocephalus presenting with headache or other symptoms of raised ICP. Solid tumours with cystic components have also been treated endoscopically.…”