Treatment of craniopharyngiomasTTreatment of craniopharyngiomasTreatment of craniopharyngiomasEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD9.0000000000000060.0000000000000233.000000000000Flat ContentHealth A-Z<p>An in-depth look at treatment possibilities for a child with a craniopharyngioma, and what the potential outcome may be.<br></p><p>There are different approaches to treatment based on the child’s age and on features of the tumour. However, because craniopharyngiomas can affect hormones, the child should first see a specialist in endocrinology before any intervention is made to remove the tumour. The endocrinologist will evaluate any damage that may have occurred to the pituitary gland and will replace any missing hormones. A craniopharyngioma is made up of solid parts and cysts. The solid parts contain calcium, and the cysts are full of fluid. </p><h2>Key points</h2> <ul><li>The type of surgery will depend on whether the tumour is mostly solid or mostly cyst.</li> <li>A child with craniopharyngioma has a very good chance of surviving.</li> <li>Long-term effects include diabetes insipidus, obesity, sleep problems, memory problems, mood swings, and damage to the pituitary gland or hypothalmus.</li></ul>
Traitement des craniopharyngiomesTTraitement des craniopharyngiomesTreatment of craniopharyngiomasFrenchNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD9.0000000000000060.0000000000000233.000000000000Flat ContentHealth A-Z<p>Examen approfondi des possibilités de traitement pour un enfant atteint d'un craniopharyngiome, et les résultat potentiel.<br></p><p>Il existe diverses méthodes de traitement, selon l'âge de l'enfant et les caractéristiques de la tumeur. Cependant, étant donné que les craniopharyngiomes peuvent avoir un effet sur les hormones, l’enfant devrait d’abord voir un spécialiste de l’endocrinologie avant que l’on tente toute intervention en vue de retirer la tumeur. L’endocrinologue évaluera tous les dommages qui auraient pu être causés à l’hypophyse et remplacera les hormones manquantes. Un craniopharyngiome est composé de parties solides et de kystes. Les parties solides contiennent du calcium, et les kystes sont remplis de liquide. </p><h2>À retenir</h2> <ul><li>La composition de la tumeur, formée surtout de parties solides ou de kystes, influencera le type d’intervention chirurgicale retenu.</li> <li>Un enfant atteint d’un craniopharyngiome présente un très bon pronostic de survie.</li> <li>Les effets à long terme peuvent comprendre le diabète insipide, l’obésité, les troubles du sommeil, les problèmes de mémoire et les sautes d’humeur ainsi que des dommages à l’hypophyse ou l’hypothalamus. </li></ul>

 

 

Treatment of craniopharyngiomas1370.00000000000Treatment of craniopharyngiomasTreatment of craniopharyngiomasTEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD9.0000000000000060.0000000000000233.000000000000Flat ContentHealth A-Z<p>An in-depth look at treatment possibilities for a child with a craniopharyngioma, and what the potential outcome may be.<br></p><p>There are different approaches to treatment based on the child’s age and on features of the tumour. However, because craniopharyngiomas can affect hormones, the child should first see a specialist in endocrinology before any intervention is made to remove the tumour. The endocrinologist will evaluate any damage that may have occurred to the pituitary gland and will replace any missing hormones. A craniopharyngioma is made up of solid parts and cysts. The solid parts contain calcium, and the cysts are full of fluid. </p><h2>Key points</h2> <ul><li>The type of surgery will depend on whether the tumour is mostly solid or mostly cyst.</li> <li>A child with craniopharyngioma has a very good chance of surviving.</li> <li>Long-term effects include diabetes insipidus, obesity, sleep problems, memory problems, mood swings, and damage to the pituitary gland or hypothalmus.</li></ul><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 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 burr hole in the skull and insert a tube into the cyst to drain it and/or he may put a permanent shunt in called an Ommaya reservoir. This can be followed by injection of chemotherapy, interferon or bleomycin directly into the cyst to help decrease the fluid being made by the walls of the cyst. This in turn makes the cyst smaller. Sometimes two or three treatments with bleomycin or interferon are needed to dry the cyst. </p><p>Some centres may use a radioactive substance such as yttrium. It is planted in part of the cyst to help shrink it.</p><p>In some cases, the craniopharyngioma may block the cerebrospinal fluid (CSF) pathway. This causes a build-up of fluid in the hollow channels of the brain called the ventricles. This is called hydrocephalus. The surgeon may need to do a small operation to place a shunt in the ventricle so the CSF can flow again. </p><h2>What is the outcome?</h2><p>A child with craniopharyngioma has a very good chance of surviving. After 10 years, about nine in 10 children with a craniopharyngioma will survive. </p><p>However, there is a large range of possible effects. Some children may have very few long-term effects. Others can have very serious long-term effects that will have a huge affect on their lives. Often, lifelong hormone replacement is needed because the tumour has damaged the pituitary gland or the hypothalamus. </p><p>Some long-term effects that may occur are "diabetes" insipidus, obesity, sleep problems, memory problems, and mood swings. </p><p>Follow-up may be very complex as it may require involvement of many doctors including the following: </p><ul><li> Neurosurgeon </li><li> Neurologist </li><li> Oncologist</li><li> Endocrinologist</li><li> Psychiatrist </li><li> Neuropsychiatrist</li></ul><p>Children sometimes need to be followed up in a comprehensive craniopharyngioma clinic.</p><p>For more information, please see:</p><ul><li> <a href="/Article?contentid=1316&language=English">Craniopharyngiomas</a></li><li> <a href="/Article?contentid=1330&language=English">Diagnosis of Craniopharyngiomas</a> </li></ul>Treatment of craniopharyngiomas

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