SBPS-07 Management of craniopharyngiomas with cystic component in the Neurosurgery Department of the Mother Child University Hospital of Bamako.

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Abstract Introduction Histologically “benign tumors”, craniopharyngiomas have “malignant locations” and are recurrent, invading the anatomical structures of the base of the skull. Their location, evolution and size make their management difficult and controversial. Various techniques are used such as excision, reservoir placement and/or injection of intracystic chemotherapy. Methodology We report a series of 7 patients, operated on and followed in the Neurosurgery Department of the Mother Child University Hospital of Bamako, over a period of 10 years. Incomplete or unusable patient files were not retained. The clinic, the size of the tumor, the location, the technique used, the quality of excision, as well as the evolution were noted and analyzed. Results The mean age of patients was 22 years (7 to 60 years) with a predominance of men (71.4% of cases). The clinic was dominated by intracranial hypertension syndrome and visual signs in all cases (blindness in 57.1% of cases). CT imaging was performed in all patients. The lesions were predominantly cystic in the majority of cases with a fleshy portion in half of the cases. Omaya reservoir placement was performed in all patients. We also performed 3 VPSs, 2 excision, 2 marsupializations, and an endoscopic procedure. Bleomycin injection was performed in 5 patients. The immediate postoperative evolution was favorable up to 3 months, we noted the total regression of the lesion in one case, 4 patients died between 6 months and 3 years of evolution. Conclusion The management of craniopharyngioma remains disappointing in our context. The injection of bleomycin does not seem to be effective but could be replaced by new therapies (interferon) on certain subtypes. Further studies are needed to support these assertions.

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