Craniopharyngioma in Adults - Neurosurgical Outcome
Craniopharyngiomas are rare tumors developed in the area of the sella turcica and especially the suprasellar region. Despite their benign histological nature they are locally aggressive and surgical intervention is a major challenge due to the risk of damaging critical neural and vascular neighbouri...
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doaj-23fa8b1804d84d738e289837a3139cd02021-06-02T16:28:48ZengMedia Med PublicisModern Medicine1223-04722360-24732019-03-012611722https://doi.org/10.31689/rmm.2019.26.1.17Craniopharyngioma in Adults - Neurosurgical OutcomeCAPATINA Cristina0DUMITRASCU Anda1CARAGHEORGHEOPOL Andra2CIUBOTARU Vasilie3POIANA Catalina4„C.I.Parhon” National Institute of Endocrinology, Bucharest,Romania„C.I.Parhon” National Institute of Endocrinology, Bucharest,Romania„C.I.Parhon” National Institute of Endocrinology, Bucharest,RomaniaDepartment of General Surgery, „Sfantul Pantelimon” Clinical Emergency Hospital, Bucharest, Romania„C.I.Parhon” National Institute of Endocrinology, Bucharest,RomaniaCraniopharyngiomas are rare tumors developed in the area of the sella turcica and especially the suprasellar region. Despite their benign histological nature they are locally aggressive and surgical intervention is a major challenge due to the risk of damaging critical neural and vascular neighbouring structures. Objective: To study the postsurgical evolution of craniopharyngioma in adults after total or partial surgical resection. Material and methods: We performed a retrospective review of adult craniopharyngioma patients evaluated and followed up in the Pituitary Diseases Department of the National Institute of Endocrinology in Bucharest between 1998 and 2018. Results: A total of 60 patients (39.62±15.6 years-old) diagnosed with craniopharyngioma were included. All underwent initial surgery (68.3 % transcranial, 31.7% transsphenoidal approach). Gross total resection (GTR) was achieved in 21 cases (35%), in all the others partial resection was obtained (non-GTR). Immediate non-threatening postsurgical complications were anosmia (in 2 cases), cerebrospinal fluid-CSF leak (3 cases), subdural hematoma (2 cases). After surgery 13 cases (21.66%) had cognitive impairment (2 with GTR, 11 with non-GTR), 14 (23.3%) had hypothalamic syndrome (diurnal sleepiness, appetite and memory dysfunction- present in 1 case with GTR, 13 with non-GTR), 27 cases (45%) reported lethargy (7 GTR, 20 non-GTR), 24 (40%) complained of headaches (6 GTR, 18 nonGTR). All these complications were significantly more frequent in cases with incomplete tumor resection compared to those with GTR: p= 0.000; 0.000; 0.036 and 0.009, respectively. Conclusions: Craniopharyngioma as well as its treatment are associated with very significant morbidity. Aggressive surgical resection with the aim of GTR is possible in a significant percentage of cases and if it is carefully considered in view of the surgically perceived risk of neurologic injury it is associated with lower postsurgical morbidity.https://medicinamoderna.ro/wp-content/uploads/2019/03/2019-1-17.pdfcraniopharyngiomaadultneurosurgeryresection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
CAPATINA Cristina DUMITRASCU Anda CARAGHEORGHEOPOL Andra CIUBOTARU Vasilie POIANA Catalina |
spellingShingle |
CAPATINA Cristina DUMITRASCU Anda CARAGHEORGHEOPOL Andra CIUBOTARU Vasilie POIANA Catalina Craniopharyngioma in Adults - Neurosurgical Outcome Modern Medicine craniopharyngioma adult neurosurgery resection |
author_facet |
CAPATINA Cristina DUMITRASCU Anda CARAGHEORGHEOPOL Andra CIUBOTARU Vasilie POIANA Catalina |
author_sort |
CAPATINA Cristina |
title |
Craniopharyngioma in Adults - Neurosurgical Outcome |
title_short |
Craniopharyngioma in Adults - Neurosurgical Outcome |
title_full |
Craniopharyngioma in Adults - Neurosurgical Outcome |
title_fullStr |
Craniopharyngioma in Adults - Neurosurgical Outcome |
title_full_unstemmed |
Craniopharyngioma in Adults - Neurosurgical Outcome |
title_sort |
craniopharyngioma in adults - neurosurgical outcome |
publisher |
Media Med Publicis |
series |
Modern Medicine |
issn |
1223-0472 2360-2473 |
publishDate |
2019-03-01 |
description |
Craniopharyngiomas are rare tumors developed in the area of the sella turcica and especially the suprasellar region. Despite their benign histological nature they are locally aggressive and surgical intervention is a major challenge due to the risk of damaging critical neural and vascular neighbouring structures. Objective: To study the postsurgical evolution of craniopharyngioma in adults after total or partial surgical resection. Material and methods: We performed a retrospective review of adult craniopharyngioma patients evaluated and followed up in the Pituitary Diseases Department of the National Institute of Endocrinology in Bucharest between 1998 and 2018. Results: A total of 60 patients (39.62±15.6 years-old) diagnosed with craniopharyngioma were included. All underwent initial surgery (68.3 % transcranial, 31.7% transsphenoidal approach). Gross total resection (GTR) was achieved in 21 cases (35%), in all the others partial resection was obtained (non-GTR). Immediate non-threatening postsurgical complications were anosmia (in 2 cases), cerebrospinal fluid-CSF leak (3 cases), subdural hematoma (2 cases). After surgery 13 cases (21.66%) had cognitive impairment (2 with GTR, 11 with non-GTR), 14 (23.3%) had hypothalamic syndrome (diurnal sleepiness, appetite and memory dysfunction- present in 1 case with GTR, 13 with non-GTR), 27 cases (45%) reported lethargy (7 GTR, 20 non-GTR), 24 (40%) complained of headaches (6 GTR, 18 nonGTR). All these complications were significantly more frequent in cases with incomplete tumor resection compared to those with GTR: p= 0.000; 0.000; 0.036 and 0.009, respectively. Conclusions: Craniopharyngioma as well as its treatment are associated with very significant morbidity. Aggressive surgical resection with the aim of GTR is possible in a significant percentage of cases and if it is carefully considered in view of the surgically perceived risk of neurologic injury it is associated with lower postsurgical morbidity. |
topic |
craniopharyngioma adult neurosurgery resection |
url |
https://medicinamoderna.ro/wp-content/uploads/2019/03/2019-1-17.pdf |
work_keys_str_mv |
AT capatinacristina craniopharyngiomainadultsneurosurgicaloutcome AT dumitrascuanda craniopharyngiomainadultsneurosurgicaloutcome AT caragheorgheopolandra craniopharyngiomainadultsneurosurgicaloutcome AT ciubotaruvasilie craniopharyngiomainadultsneurosurgicaloutcome AT poianacatalina craniopharyngiomainadultsneurosurgicaloutcome |
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1721402698188718080 |