Craniopharyngiomas. A clinical and pathological review

Abstract

Two hundred and forty-five cases of craniopharyngiomas were obtained from the files of the AFIP and reviewed statistically with reference to their gross and microscopic appearance and clinical data. The majority of the tumors were cystic and microscopically, cysts were formed by squamous epithelial maturation, by degeneration of the stellate cells at the centers of adamantinomatous nests, or by degeneration of the stroma. Transitional forms were seen between adamantinomatous and squamous epithelium and keratohyaline granules and keratin were present in some cases. Because of this overlap, differentiation between craniopharyngiomas and suprasellar epidermoid cysts often is not possible. Significantly increased acturial survival rates were associated with absence of calcification in plain skull films in adults, negative CSF examination, and tumor size under 3.0 cm.

Metastatic papillary craniopharyngioma: Case study and study of tumorangiogenesis

“…The clinicopathologic study of Duff et al (2000) also found lethargy, visual deterioration, papilledema, hydrocephalus, and adhesive tumor growth to be associated with a poorer outcome. Most studies of craniopharyngiomas indicate that radiation treatment is strongly associated with tumor regression or lack of recurrence (Duff et al, 2000;Eldevick et al, 1996;Petito et al, 1976). No radiation therapy was administered in the present case.…”

“…In addition to remote metastases (Gupta et al, 1999;Ito et al, 2001), rare examples of craniopharyngioma arise in ectopic locations, including the pineal gland (Solarski et al, 1978), sphenoid bone (Cooper and Ransohoff, 1972), cerebellopontine angle (Gökalp et al, 1991), optic chiasm (Duff and Levine, 1983), and nasopharynx (Majlessi et al, 1978). Neuro-Oncology A P R I L 2 0 0 2 Directly or indirectly, neuroimaging (Crotty et al, 1995;Sorva et al, 1987) and clinicopathologic studies (Crotty et al, 1995;Petito et al, 1976) have documented the occurrence of 2 forms of craniopharyngioma, the adamantinomatous and papillary variants. Adamantinomatous-type tumors predominate, are suprasellar in location, and often show intrasellar extension (Burger and Scheithauer, 1994;Duff et al, 2000;Petito et al, 1976).…”

“…Neuro-Oncology A P R I L 2 0 0 2 Directly or indirectly, neuroimaging (Crotty et al, 1995;Sorva et al, 1987) and clinicopathologic studies (Crotty et al, 1995;Petito et al, 1976) have documented the occurrence of 2 forms of craniopharyngioma, the adamantinomatous and papillary variants. Adamantinomatous-type tumors predominate, are suprasellar in location, and often show intrasellar extension (Burger and Scheithauer, 1994;Duff et al, 2000;Petito et al, 1976). Most occur in children and young adults.…”

“…Several authors (Kahn et al, 1973;Petito et al, 1976) have stated that lack of recurrence and a better outcome are associated with tumors of adulthood that lack radiographic evidence of calci cation. In addition, Petito et al (1976) stated that the patients with tumors measuring less than 3.0 cm survive signi cantly longer than patients with larger lesions.…”

“…In addition, Petito et al (1976) stated that the patients with tumors measuring less than 3.0 cm survive signi cantly longer than patients with larger lesions. That same study found no correlation between survival and the ratio of adamantinomatous to squamous components (Petito et al, 1976). In our study, the tumor lacked CT evidence of calcification, but exceeded 3 cm in size, at both presentation and recurrence.…”