Craniopharingiomas
What is it?
Craniopharyngioma is a benign ephitelial tumor arising in in sovrasellar and sellar region. It represents the third most common intracranial tumor in children. Despite the benign nature it usually have a aggressive clinical course.
Which are the symptoms?
Craniopharyngiomas may reach large size before giving any symptom: visual disturbance, Monolateral or bilateral, hypopituitarism, intracranial hypertension, cognitive impairment and personal changes (> 50% of patients).
How is it diagnosed?
Suggested exams
How is it treated?
Surgery. Craniopharyngiomas are relatively rare tumors, so it is important that the patient is referred to a high-volume dedicated center. Radical resection is associated with the best outcome in terms of survival and recurrence-free survival. However, long-term sequelae may reduce significantly patients quality of life. A skilled surgeon will choose the best surgical approach between an aggressive surgery versus a more conservative approach followed by radiotherapy to treat the residual disease.
- Transsphenoidal approach
- Trasncranial approach (fronto-temporal or fronto-orbito-zygomatic; subfrontal; subtemporal; interhemispheric transcallosal transventricolar).
Radiation therapy (fractionated radiotherapy, stereotactic radiosurgery or interstitial). Is indicarted as the first line in elderly patients, in patients with poor performance status, or in recurrent cystic tumor. Complications include radionecrosis, hypopituitarism and dementia.
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