Management of Craniopharyngioma

Abstract

Objective: Craniopharyngiomas are one of the most challenging problems for neurosurgeons because of the high recurrence rates due to their localization and associated endocrinological disorders. This study reports the outcomes of surgeries and recurrence rates of 45 craniopharyngioma cases. Method: Patients who were diagnosed with craniopharyngioma in the authors’ clinic between 1998 and 2016 evaluated retrospectively. Results: A total of 45 patients (25 males and 20 females; age, 3–56 years) who had previously undergone surgery for craniopharyngioma were enrolled and followed up for 12 to 222 months (mean follow-up duration, 73.5 ± 55.2 months). Among these, 25 were children (55.5%) with a mean age of 9.5 ± 4.6 years and 20 were adults (45.5%) with a mean age of 37.2 ± 12.7 years. A total of 39 (86.6%) patients underwent total tumor resection, while 6 (13.4%) underwent subtotal tumor removal. During 12 to 30 months of follow-up, the progression of residual tumor was recorded in 4 patients, 3 of whom underwent surgery and postoperative radiotherapy. Despite the total resection of tumor in their first surgery, 3 patients showed tumor recurrence during 15 to 34 months of the follow-up. Conclusion: Our findings suggest that the total resection of craniopharyngiomas, when possible, results in a favorable quality of life, with acceptable mortality and morbidity rates.

Non-Invasive Radiomics Approach Predict Invasiveness of Adamantinomatous Craniopharyngioma Before Surgery

“…In our cohort, there were more male patients (n = 187, 55.82%) than female patients (n = 148, 44.18%), consistent with previous reports ( 29 – 31 ). Although CPs were more common among child patients, the proportion of adult patients was higher in this study (84.78 vs. 15.22%); because adult patients were the main group of patients in our ward.…”

Diagnosis and Treatment of Pediatric Brain Tumors

“…Craniopharyngiomas are histologically benign neuroepithelial tumors of the central nervous system (CNS) with malignant behavior, which are predominantly observed in children aged 5 to 10 years. These lesions tend to invade surrounding structures and to recur after a total resection (13,14). Two of 4 craniopharyngiomas in this study showed a recurrence during the follow-up period, and reoperation was needed.…”

CD47 promotes the proliferation and migration of adamantinomatous craniopharyngioma cells by activating the MAPK/ERK pathway, and CD47 blockade facilitates microglia‐mediated phagocytosis

“…At the same time, the results also showed that ACP involved the hypothalamus to varying degrees, and even in tissue specimens from the same patient, there were significant differences in the degree of tumour involvement of the hypothalamus in different regions (Figure S2a–c). It has been previously reported that the finger‐like protrusions of ACP appear to be related with the recurrence [3, 22–24]. Therefore, the finger‐like protrusions of ACP could be an important factor in tumour recurrence.…”

“…ACP accounts for nearly 90% of CP cases, and its management remains one of the most challenging issues for neurosurgeons. Although it is histologically benign, ACP usually infiltrates the adjacent structures, such as the pituitary, hypothalamus, optic nerves, vascular structures and the third ventricle, often making a complete surgical resection difficult or even unfeasible [3]. Despite resection with or without radiotherapy, the rate of recurrence remains relatively high ($25%) [4,5].…”