Total Removal of Giant Craniopharyngioma

Gaidar B.V., Cherebillo V.Yu.

(Chair of Neurosurgery of the Medicomilitary Academy)

Female patient P., aged 26, was treated in the Clinic of Neurosurgery of the Medicomilitary Academy since September 22 up to November 3, 1999. The patient suffered from severe headache during the last five years. CT examination revealed giant tumor of the skull base.

On admission the patient was in a subcompensated state; there were marked common cerebral symptoms; focal neurologic symptoms were absent. Findings of CT of the brain and selective cerebral angiography were indicative of basal tumor, growing from the saddle dorsum, its diaphragm and spreading upwards and to the clivus. The tumor's diameter was about 5 cm; its outlines were even and distinct; its density was about 80 H units. The third ventricle was almost occluded, deformed and displaced upwards. Angiographic examination allowed to visualize the tumor's own network, going along its capsule from the saddle dorsum to the clivus.

The patient was operated on October 18, 1999. Osteoplastic trephination in the right occipitotemporoparietal area and removal of tumor, using the supratentorial approach, were performed (Prof. Gaidar B.V.). A postoperative period was favorable. On discharge the patient was in a satisfactory general state; there were no common cerebral symptoms and neurologic deficit. Control CT examination of October 26, 1999 revealed signs of tumor total removal and a liquor cyst in a zone of the resected tumor.

The demonstration goal:

To discuss potentialities of surgical approaches in removal of giant tumors of the skull base and the third ventricle.