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.


Diabetes Insipidus Optic Pathway Pituitary Stalk Tumoral Capsule Lamina Terminalis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Ammirati M, Samii M, Sephernis A (1990) Surgery of large retrochiasmatic craniopharyngioma in children. Childs Nerv Syst 6:13–17PubMedCrossRefGoogle Scholar
  2. 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
  3. 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
  4. Carmel PW, Antunez JL, Chang CH (1982) Craniopharyngiomas in children. Neurosurgery 11:382–389PubMedCrossRefGoogle Scholar
  5. Cavazuti V, Fischer EG, Welch K (1983) Neurological and psychological sequelae following different treatments of craniopharyngioma in children. J Neurosurg 59:409CrossRefGoogle Scholar
  6. Choux M, Lena G (1979) Bases of surgical management of craniopharyngioma in children proceedings. Acta Neurochir Suppl (Wien) 28:348Google Scholar
  7. Choux M, Lena G, Genitori L (1991) Le craniopharyngiome de l’Enfant.Neurochirurgie 37:1 -174Google Scholar
  8. Ciric I (1977) On the origin and nature of the pituitary gland capsule. J Neurosurg 46:596–600PubMedCrossRefGoogle Scholar
  9. Fischer EG, Welch K, Belli JA, Wallman J, Shillito J Jr, Winston KR, Cassady R (1985) Treatment of craniopharyngiomas in children (1972–1981). J Neurosurg 62:496–501PubMedCrossRefGoogle Scholar
  10. Hoffman HJ, Hendrick EB, Humphreys RP Buncic JR Armstrong DL, Jenkin RD (1977) Management of craniopharyngioma in children. J Neurosurg 47:218–227PubMedCrossRefGoogle Scholar
  11. Katz EL (1975) Late results of radical excision of craniopharyngiomas in children. J Neurosurg 47:86–93CrossRefGoogle Scholar
  12. Kobayashi T, Kageyama N, Ohara K (1981) Internal irradiation for cystic craniopharyngioma. J Neurosurg 55:896–903PubMedCrossRefGoogle Scholar
  13. 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
  14. Lapras C, Patet JD, Mottolese C, Gharbi S, Lapras C jr (1987) Craniopharyngiomas in childhood: analysis of 42 cases. Prog Exp Tumor Res 30:350–358PubMedGoogle Scholar
  15. Laws ER jr (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52:661–666Google Scholar
  16. Mori K, Handa H, Murata T, Takeuchi J, Miwa S, Osaka K (1980) Results of treatment for craniopharyngioma. Childs Brain 6:306–312Google Scholar
  17. Pierre-Kahn A, Brauner R, Renier D, Sainte-Rose C, Gangemi MA, Rapport R, Hirsch JF (1988) Traitement des craniopharyngiomes de l’enfant. Analyse rétrospective de 50 observations. Arch Fr Pediatr 45:163–167PubMedGoogle Scholar
  18. 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
  19. Shapiro K, Till K, Grant DN (1979) Craniopharyngiomas in childhood. A rational approach to treatment. J Neurosurg 50:617–623PubMedCrossRefGoogle Scholar
  20. Shillito J jr (1986) Treatment of craniopharyngioma. Clin Neurosurg 33:533–546PubMedGoogle Scholar
  21. Steno J (1985) Microsurgical topography of craniopharyngiomas. Acta Neurochir Suppl (Wien) 35:94–100CrossRefGoogle Scholar
  22. 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
  23. Symon L, Sprich W (1985) Radical excision of craniopharyngioma. Results in 20 patiens. J Neurosurg 62:174–181PubMedCrossRefGoogle Scholar
  24. 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

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© Springer-Verlag Italia 1995

Authors and Affiliations

  1. 1.Department of Pediatric NeurosurgeryHôpital des EnfantsLa Timone MarseilleFrance

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