2000 Volume 9 Issue 11 Pages 747-752
We report a case of a large recurrent craniopharyngioma successfully treated with gamma-knife radiosurgery followed by intratumoral injections of bleomycin. This 27-year-old woman was first treated with subtotal removal of the tumor via the rigth pterional approach and postoperative external radiotherapy at the age of 12 years. Ten years later, magnetic resonance imaging (MRI) revealed regrowth of the tumor. Since then, she has undergone tumor removal surgery 4 times over a 5 years period through either a pterional or transsphenoidal approach, but each attempt proved unsuccessful. In 1997, She was treated with gamma-knife radiosurgery (central dose 30 Gy, marginal dose 15Gy ; 5 fractionated). After 1 week, because of expansion of the cystic part, she received a craniotomy and an Ommaya tube was inserted into the cyst. Two months later, intratumoral injections of bleomycin were started as an adjuvant therapy. Twelve months after the treatment, an MRI revealed significant reduction of the tumor without any side effects.