Issues concerning the treatment of a child with a craniopharyngioma

✍ Scribed by Glod, John ;Koch, Bernadette ;Myseros, John ;Breneman, John ;Collins, Margaret H.

• Publisher: John Wiley and Sons
• Year: 2002
• Tongue: English
• Weight: 235 KB
• Volume: 38
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.1346

✦ Synopsis

The case being presented is that of a 6-year-old boy with craniopharyngioma. The discussion centers on the controversy regarding the optimal therapy for craniopharyngioma: surgery alone; radiotherapy alone, or combined therapy using both surgery and radiation. This patient was treated with biopsy and radiotherapy and the reasons for that decision are discussed.

J.F. is a 6-year-old male who complained of intermittent headaches beginning 1 year prior to admission. The headaches were occasionally accompanied by emesis. Over the course of several weeks prior to his admission, the headaches became progressively worse. He was seen by his primary physician and no abnormalities on neurologic examination were noted. His parents did not describe any changes in school performance or personality. He was referred here by his primary care physician for a CT of the head to evaluate his worsening headaches.

The oncology service was consulted after radiographic evaluation. J.F. was alert and in no distress. His physical examination was unremarkable. There was no papilledema. Neurologic evaluation showed normal strength and tone in all four extremities with normal, symmetric deep tendon reflexes. There were no cranial nerve abnormalities or cerebellar signs. His weight was 23 kg (50%ile). He did not have symptoms of polyuria or polydipsia, or vision changes. Laboratory evaluation showed an elevated prolactin at 47.1 ng/ml and a low IGF-I at 55 ng/ml, but was otherwise normal (see Table I).