Craniopharyngioma in Children: Surgical Considerations
The management of craniopharyngiomas, especially in childhood, remains a controversial and challenging subject (Carmel et al. 1982; Fischer et al. 1985; Katz 1975; Yasargil et al. 1990). This histologically benign tumor is of maldevelopmental origin and develops in a particular intracranial location, close to the optic pathways, the hypothalamus, the hypophysis, and the internal carotid arteries and their main branches. Its spontaneous evolution is unforeseeable. The location and firm attachment to important surrounding anatomical structures make its surgical extirpation possible, but difficult and risky. Other therapeutic modalities have been proposed, such as conventional or interstitial irradiation or even chemotherapy. The choice of one or another treatment depends on the patient’s age, the aspects of the lesion, the skyll of the surgeon, and, moreover, the personal opinion and the firm belief of the physician. Consequently, it is not so easy to establish a definitive protocol for the management of craniopharyngioma. We have tried in this presentation to present our personal therapeutic approach to this tumor, considering exclusively the pediatric age.
KeywordsDiabetes Insipidus Optic Pathway Pituitary Stalk Tumoral Capsule Lamina Terminalis
Unable to display preview. Download preview PDF.
- Backlund EO, Axelsson B, Bergstrand CG, Eriksson AL, Noren G, Ribbesio E, Rahn T, Schnell PO, Tallstedt L, Saaf M, et al (1989) Treatment of craniopharyngiomas the stereotactic approach in a ten to twenty-three years perspective. Surgical radiological and ophthalmological aspects. Acta Neurochir (Wien) 99:11–91CrossRefGoogle Scholar
- Broggi G, Giorgi C, Franzini A, Servello D, Solero CL (1989) Preliminary results of intracavitary treatment of craniopharyngiomas with bleomycin. J Neurosurg Sei 33:145–148Google Scholar
- Choux M, Lena G (1979) Bases of surgical management of craniopharyngioma in children proceedings. Acta Neurochir Suppl (Wien) 28:348Google Scholar
- Choux M, Lena G, Genitori L (1991) Le craniopharyngiome de l’Enfant.Neurochirurgie 37:1 -174Google Scholar
- Konovalov AN (1987) Technique and strategies of direct surgical management of craniopharyngiomas. In: Apuzzo M (ed) Surgery of the third ventricle. Williams and Wilkins, Baltimore, 542–552Google Scholar
- Laws ER jr (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52:661–666Google Scholar
- Mori K, Handa H, Murata T, Takeuchi J, Miwa S, Osaka K (1980) Results of treatment for craniopharyngioma. Childs Brain 6:306–312Google Scholar
- Raimondi AJ, Rougerie J (1983) A critical review of personal experiences with craniopharyngioma: clinical history, surgical techniques, and operative results. Cone Pediatr Neurosurg 3:1–34Google Scholar
- Sweet WH (1988) Craniopharyngiomas (with a note on Rathke’s cleft or epithelial cyst and on suprasellar cyst). In: Schmidek HM, Sweet WH (ed) Operative neurosurgical techniques. Grune and Stratton, Orlando, pp 349–379Google Scholar
- Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P (1990) Total removal of craniopharyngioma. Approach and long-term results in 144 patients. J Neurosurg 73:11Google Scholar