✓ A case of craniopharyngioma associated with true precocious puberty is reported in a child operated on when she was 2 years and 8 months of age. Precocity was noted 10 months after operation and was fully documented 1 year later. A pneumoencephalogram showed a recurrence of tumor in the hypothalamic area. Hormonal therapy was instituted to stop sexual maturation. Reoperation was undertaken only when her visual symptoms reappeared. She received a postoperative course of radiotherapy. On last examination, she was neurologically well, and computerized tomography did not show further growth of the residual tumor. The diagnosis of precocious puberty and its etiology in this patient are discussed.
José M. Cabezudo, Carmelo Perez, Jesús Vaquero, Rafael Garcia-De-Sola and Gonzalo Bravo
José M. Cabezudo, Jesús Vaquero, Eduardo Areitio, Roberto Martinez, Rafael García de Sola and Gonzalo Bravo
✓ The authors have conducted a retrospective statistical study in a series of 45 patients with craniopharyngiomas in order to assess the value of different therapeutic approaches. All the patients included in the study were placed in three groups according to their method of treatment: 1) total excision; 2) subtotal excision; and 3) surgery followed by a course of radiotherapy (RT). Symptomatic recurrence was used to define failure of treatment. Of the patients subjected to total excision, 30% experienced recurrence after a mean time of 2 years. Tumors recurred in 71% of those treated by subtotal excision, with a mean time of 2.6 years. Of patients receiving RT in addition to surgery, only 6% had recurrence, after a mean time of 1 year. The authors conclude that the elective treatment for craniopharyngiomas is controlled subtotal surgery plus RT. Total excision should be attempted only if there is a negligible danger of mortality.