Follow up assessment on the first local theranostic intra-cavitary Yttrium-90 citrate colloid irradiation for refractory cystic craniopharyngioma: Is it still a valuable treatment option?

Craniopharyngioma is a rare, benign intracranial tumour that can present with solid, cystic, or mixed solid-cystic characteristics. This case report aims to discuss the follow up assessment of our patient after one year of the irradiation therapy for craniopharyngioma. A 43-year-old male who has underlying refractory cystic craniopharyngioma requiring two-weekly aspirations, complicated with visual impairment and panhypopituitarism, was referred to our department for intra-cavitary irradiation therapy. Initial diagnostic assessment with Tc-99m MAA followed by dose calculation using the Backlund formula were conducted prior to the therapy. The patient received 6.22 mCi (230.14 MBq) of Ytrrium-90 citrate colloid via the Ommaya reservoir to deliver a radiation dose of 300 Gy to the tumour. Positive outcomes were observed as signified by the reduction on the aspirated cystic frequency and volume, tumour volume, improvement on the visual function and stable hormonal level. Despite the complications, the intra-cavitary irradiation therapy has demonstrated a significant and valuable therapeutic option for our patient in the management of refractory cystic craniopharyngioma.