J Neurol Surg A Cent Eur Neurosurg 2013; 74(05): 307-312
DOI: 10.1055/s-0033-1341413
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Treatment of Cystic Craniopharyngioma by Endocavitary Instillation of Yttrium90 Radioisotope—Still a Valuable Treatment Option

Dimitri Vanhauwaert
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
Giorgio Hallaert
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
Edward Baert
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
Dirk Van Roost
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
Jean-Pierre Kalala Okito
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
Jacques Caemaert
1   Department of Neurosurgery, UZ Gent, Gent, Belgium
› Author Affiliations
Further Information

Publication History

15 February 2012

20 December 2012

Publication Date:
22 March 2013 (online)


Craniopharyngiomas are a challenging pathology in neurosurgery because of their anatomic localization in the (supra)sellar region and their contact with diencephalic structures around the third ventricle. Among the different treatment modalities, stereotactic intracavitary treatment by instillation of yttrium90 radioisotope is a minimally invasive technique of particular use in the treatment of cystic or partially cystic craniopharyngiomas. It can be performed under local anesthesia during a short hospitalization and has a long-lasting effect. This treatment can be repeated or used in combination with other treatment modalities such as microsurgery, endoscopy, conformal external radiation therapy, or stereotactic radiosurgery. Thus, this old and perhaps almost forgotten treatment option is still valuable in the treatment of cystic craniopharyngiomas.

  • References

  • 1 Samii M, Tatagiba M. Craniopharyngioma. In: Kaye AH, Laws ER, , eds. Brain Tumors. An Encyclopedic Approach. London: Churchill Livingstone; 2001: 945-964
  • 2 Janzer RC, Burger PC, Giangaspero F, Paulus W. Craniopharyngioma. In: Kleihues P, Cavanee WK, , eds. WHO Classification of Tumors of the Nervous System. Lyon: IARC Press; 2000: 244-246
  • 3 Blackburn TP, Doughty D, Plowman PN. Stereotactic intracavitary therapy of recurrent cystic craniopharyngioma by instillation of 90yttrium. Br J Neurosurg 1999; 13: 359-365
  • 4 Musolino A, Munari C, Blond S , et al. [Stereotaxic treatment of expanding cysts in craniopharyngiomas by endocavitary beta-irradiation (Re-186; Au-198; Y-90)]. Neurochirurgie 1985; 31: 169-178
  • 5 Pollack IF, Lunsford LD, Slamovits TL, Gumerman LW, Levine G, Robinson AG. Stereotaxic intracavitary irradiation for cystic craniopharyngiomas. J Neurosurg 1988; 68: 227-233
  • 6 Leksell L, Liden K. A therapeutic trial with radioactive isotopes in cystic brain tumor. In: Radioisotope Techniques. Vol. 1: Medical and Physiological Applications. London: Her Majesty's Stationary Office; 1952: 76
  • 7 Leksell L, Backlund EO, Johansson L. Treatment of craniopharyngiomas. Acta Chir Scand 1967; 133: 345-350
  • 8 Backlund EO. Studies on craniopharyngiomas. I. Treatment: past and present. Acta Chir Scand 1972; 138: 743-747
  • 9 Backlund EO, Johansson L, Sarby B. Studies on craniopharyngiomas. II. Treatment by stereotaxis and radiosurgery. Acta Chir Scand 1972; 138: 749-759
  • 10 Backlund EO, Axelsson B, Bergstrand CG , et al. Treatment of craniopharyngiomas—the stereotactic approach in a ten to twenty-three years' perspective. I. Surgical, radiological and ophthalmological aspects. Acta Neurochir (Wien) 1989; 99: 11-19
  • 11 Lunsford LD, Levine G, Gumerman LW. Comparison of computerized tomographic and radionuclide methods in determining intracranial cystic tumor volumes. J Neurosurg 1985; 63: 740-744
  • 12 Backlund EO. Studies on craniopharyngiomas. 3. Stereotaxic treatment with intracystic yttrium-90. Acta Chir Scand 1973; 139: 237-247
  • 13 Voges J, Sturm V, Lehrke R, Treuer H, Gauss C, Berthold F. Cystic craniopharyngioma: long-term results after intracavitary irradiation with stereotactically applied colloidal β-emitting radioactive sources. Neurosurgery 1997; 40: 263-269 , discussion 269–270
  • 14 Julow J, Backlund EO, Lányi F , et al. Long-term results and late complications after intracavitary yttrium-90 colloid irradiation of recurrent cystic craniopharyngiomas. Neurosurgery 2007; 61: 288-295 , discussion 295–296
  • 15 Van den Berge JH, Blaauw G, Breeman WA, Rahmy A, Wijngaarde R. Intracavitary brachytherapy of cystic craniopharyngiomas. J Neurosurg 1992; 77: 545-550
  • 16 Cáceres A. Intracavitary therapeutic options in the management of cystic craniopharyngioma. Childs Nerv Syst 2005; 21: 705-718
  • 17 Abdullah J, Caemaert J. Endoscopic management of craniopharyngiomas: a review of 3 cases. Minim Invasive Neurosurg 1995; 38: 79-84
  • 18 Hukin J, Steinbok P, Lafay-Cousin L , et al. Intracystic bleomycin therapy for craniopharyngioma in children: the Canadian experience. Cancer 2007; 109: 2124-2131