Should Adjuvant Radiotherapy Be Recommended for Pediatric Craniopharyngiomas?

Intracranial tumors secondary to radiotherapy are rare. In this group gliomas are the rarest. Only 6 cases of glioblastoma multiforme (GBM) have been reported in patients undergoing radiotherapy (RT) for craniopharyngiomas of which only 4 have been in children less than 18 years of age. In recent years RT has become a mainstay of adjuvant therapy for recurrent or partially excised craniopharyngiomas. We report a child of 12 years who had previously undergone RT for a suprasellar craniopharyngioma and presented 10 years later with a GBM. This is the 5th pediatric case in literature demonstrating a GBM after RT for a craniopharyngioma. The implications of subjecting the pediatric population to RT for a benign lesion versus the outcome of gross total removal and management of RT induced tumors is discussed and the need to avail of safer alternatives such as stereotactic radiosurgery is stressed.

Pontomedullary white epidermoid: a rare cause of tinnitus

Intracranial epidermoid cysts are relatively rare congenital inclusion cysts. They are the third most common cerebellopontine angle cistern mass after vestibular schwannoma and meningioma. White epidermoid is a rare variant. We present the first case, to our knowledge, of a white epidermoid cyst anterior to the pontomedullary junction, emphasising its imaging appearance, location and the importance of pre-operative diagnosis, which may reduce operative complications.

Multiple fourth ventricular hydatidosis.

Hydatid disease caused by ingestion of eggs of the cestode Echinococcus granulosus is endemic in the Middle East, Mediterranean countries, South America, North Africa and Australia.(1) Infratentorial occurrence of hydatid cyst is rare. We present a report of an extremely rare case of multiple exclusive fourth ventricular hydatid cysts, both primary and secondary, and discuss problems with the diagnosis and management of this condition.