الفهرس 
History Of CraniopharyngiomaOnly 14 pages are availabe for public view
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Abstract
Introduction: Craniopharygiomas are rare epithelial tumors arising along the path of the craniopharyngeal duct. Despite their benign histological appearance, their often infiltrative tendency into critical suprasellar structures and their aggressive behavior, even after apparently successful therapy, may result in significant morbidity and mortality posing a considerable medical and social problem. The Purpose: to evaluate craniopharyngioma patients based on clinical, radiological, operative features, and outcome, and to assess the role and effectiveness of bleomycin for cystic craniopharyngiomas. Patient and methods: This is prospective study include 34 cases of craniopharyngioma have been treated during last 3 years at Zagazig and Mansoura university hospitals, every case was subjected to full clinical, laboratory, and radiological evaluation. The final outcome was assessed functionally utilizing Karnofsky performance scale and other criteria described by Duff et al 2000. Results: Headache is most common complaint among craniopharyngiomas, observed in 32(94.1%) of patient, followed by visual impairment in 29 (85.3%), endocrinal dysfunction in 24 (70%) patients. Surgery was carried out for 29 cases in an attempt for safe gross total excision. Ommaya reservoir was inserted in 18 patients; local chemotherapy was performed in 9 patients. We followed up 30/34 patients were followed up for a period ranged from 12 months to 48 months with mean follow up period of 25.4 months Recurrence represents one of the most common complications of craniopharyngioma treatment and poses many problems as to management. It occurred in 17 (50%) patients, total overall mortality was 12 patients died at the end of March 2007 constitute 35.3% of the series. With the criteria described in patients and methods, 15 patients (41.1%) were characterized as achieving favorable outcomes and 19 patients (58.9%) as achieving non favorable outcomes. Results of bleomycin therapy: Complete disappearance of cyst in 1/9 patient, reduction of cyst more than 50 % of cyst volume in 5/9, reduction of cyst less than 50% in 1/9 cases, one case had no change, One child had tumor progression necessitate surgical interference. It means tumor control was achieved in 7 of 9 cases. No mortality or major morbidity in bleomycin group. Conclusion: The craniopharyngiomas remain challenging and often enigmatic tumors; despite their benign histological appearance, they are often associated with unfavorable and occasionally disastrous sequelae However, the difficulty in managing craniopharyngiomas has led to exploration of the role of chemotherapy in this tumor. Intracystic bleomycin was found to be well tolerated in the majority patient in this study. It decreases and stabilizes tumor size, and thus may be considered as an option of treatment modalities in patients with predominantly cystic craniopharyngiomas