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Treatment strategies for craniopharyngiomas.

TitleTreatment strategies for craniopharyngiomas.
Publication TypeJournal Article
Year of Publication2019
AuthorsOttenhausen M, Rumalla K, La Corte E, Alalade A, Nair P, Forbes J, Ben Nsir A, Schwartz TH
JournalJ Neurosurg Sci
Volume63
Issue1
Pagination83-87
Date Published2019 Feb
ISSN1827-1855
KeywordsCraniopharyngioma, Humans, Neurosurgical Procedures, Pituitary Neoplasms, Sella Turcica
Abstract

Craniopharyniomas arise from the sellar region and are particularly challenging because of their close proximity to critical neurovascular structures, including cranial nerves, brainstem, internal carotid arteries, posterior cerebral arteries, hypothalamus, and the pituitary gland. The tumors are benign on histology but can cause serious symptoms by compression of surrounding vital structures. While radical surgery and gross total resection (GTR) remains the first line treatment, choosing the optimal surgical approach is critical for the minimization of complications and postoperative morbidity. The extended endoscopic endonasal approach (EEEA) offers a direct route towards the sellar and suprasellar regions and has proven to be a safe and effective for GTR, with lower rates of complications and postoperative morbidity than open transcranial approaches. However, traditional transcranial approaches remain relevant in tumors with significant lateral extension. Radiotherapy can be considered in cases of subtotal resection (STR) or if surgery is not possible, although progressive growth of cysts with neurological deterioration has been demonstrated no infrequently. Newly developed chemotherapy for papillary craniopharygniomas might expand treatment options in the future.

DOI10.23736/S0390-5616.17.04171-6
Alternate JournalJ Neurosurg Sci
PubMed ID28869375