Total excision is a treatment of choice in preventing the relapse of craniopharyn-gioma, but for tumors involving an extensive area, it is often associated with an increased risk of complications. We have performed a partial or subtotal tumor removal followed by repeated injection of bleomycin into the remaining tumor through a subcutaneous reservoir as postoperative adjuvant therapy. A retro-spective review of clinical, radiological, and surgical data was performed for 10 patients (5 males and 5 females; age, 3-65 yr; follow-up duration, 12-79 months) with cystic craniopharyngiomas. The measurements of lactate dehydrogenase (LDH) level at each aspiration were performed. The shrinkage and/or stabiliza-tion of tumor was initially noted in all cases. The recurrence of tumor was seen in 4 cases (40%). The decreased or increased level of LDH was interpreted as tumor shrinkage or recurrence, respectively. The transient toxic reactions were observed in 3 patients (30%). Our study demonstrates that postoperative bleo-mycin injection for cystic craniopharyngioma, although does not appear to eradi-cate the tumor, decreases and stabilizes the tumor size, when used as an adju-vant therapy in young patients.
Adolescent ; Adult ; Aged ; Antibiotics, Antineoplastic/administration & dosage/adverse effects/*therapeutic use ; Bleomycin/administration & dosage/adverse effects/*therapeutic use ; Brain/radiation effects ; Child ; Child, Preschool ; Craniopharyngioma/*drug therapy/radiography/surgery ; Female ; Follow-Up Studies ; Humans ; Injections ; L-Lactate Dehydrogenase/metabolism ; Male ; Middle Aged ; Pituitary Neoplasms/*drug therapy/radiography/surgery ; *Postoperative Care ; Retrospective Studies ; Tomography, X-Ray Computed/methods