Neurological Surgery No Shinkei Geka Volume 26, Issue 3 (March 1998)

Transsphenoidal Surgery and Gamma-knife Radiosurgery for a Treatment of Recurrent Craniopharyngioma with Moyamoya Vessels Hideo KUCHIKI 1 , Koki KATAKURA 1 , Toshihiko KINJO 1 , Kiyoshi SATO 1 , Takamasa KAYAMA 1 1Department of Neurosurgery, Yamagata University School of Medicine Keyword: craniopharyngioma , gamma knife , moyamoya , radiosurgery pp.273-278
Published Date 1998/3/10
  • Abstract
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A recurrent craniopharyngioma associated with moyamoya vessels was successfully treated by partial re-moval of the tumor via the transsphenoidal approach followed by gamma-knife radiosurgery. This 19-year-old man was first treated by partial tumor removal and radiotherapy (54Gy) at the age of 6 years. Growthhormone and human chorionic gonadotropin were given from the ages of 13 to 18 years. At ag 17 years,follow-up magnetic resonance imaging (MRI) revealed regrowth of the tumor. At the age of 19 years, hewas readmitted for treatment of the enlarging remnant tumor. Neurological examination revealed bilateralblindness. MRI showed marked suprasellar, sphenoidal and bilateral cavernous sinus extension of thetumor. Angiography revealed stenosis of the right internal carotid artery and the M1 and A1 segments ofthe right cerebral arteries, as well as occlusion of the C3 segment of the left internal carotid artery. Therewere vault and ethmoidal moyamoya vessels. The patient underwent tumor removal via the transsphenoid-al approach, instead of craniotomy, to avoid injury to the transdural anastomosis. The intrasellar solidtumor was partially removed. The tumor was then irradiated by the gamma knife. MRI 15 months afterthe treatment showed marked reduction of the tumor. The pathogenesis of the moyamoya pllenomenonand the choice of treatment in this patient are discussed.

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Neurological Surgery 脳神経外科
26巻3号 (1998年3月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院