Medscape is available in 5 Language Editions – Choose your Edition here.


Surgery for Craniopharyngiomas Treatment & Management

  • Author: Lawrence S Chin, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
Updated: Jan 21, 2015

Medical Therapy

No primary medical therapy exists for this tumor. Hormonal replacements are administered as needed if endocrine abnormalities exist.


Surgical Therapy

The initial surgical decision concerns the approach. If the predominant portion of the tumor is intrasellar, the approach is usually transsphenoidal. Often, the suprasellar component can be delivered into the sella and evacuated. Further, the transsphenoidal approach is well tolerated by patients and is preferable to a craniotomy, when feasible.[19, 20, 21, 22, 23, 24, 25, 26]

If the pituitary sella is not enlarged, the transsphenoidal approach is generally not preferred. A craniotomy is usually necessary when the predominant component is suprasellar, although certain suprasellar masses may be located through an extended transsphenoidal approach. New technology in optics and instrumentation has now permitted many transsphenoidal procedures to be done exclusively through the endoscope. Specialized training is needed in these techniques, but in some instances, even large tumors in the suprasellar space can be safely removed or debulked.[27, 28, 29]

The pterional craniotomy is the standard craniotomy approach to suprasellar lesions because it allows good visualization of the optic nerves, chiasm, and surrounding structures. Variations of the pterional craniotomy have been proposed to include resection of the orbital rim and zygoma so as to provide a more defined view of the skull base and thereby allow better access to the superior aspects of this tumor. These approaches lend themselves to less frontal lobe retraction in order to visualize the operative site.

A subfrontal approach is appropriate for lesions that lie anterior to the optic chiasm, but this may be difficult to determine preoperatively. Under rare circumstances, a transcallosal approach is necessary when the tumor is entirely within the third ventricle. The drawback to this approach is the inability to identify the optic chiasm and pituitary stalk early in the dissection.

Cystic tumors are amenable to either a transsphenoidal approach or a pterional craniotomy. The solid components often adhere to the optic chiasm or hypothalamus and, therefore, may be difficult to remove in their entirety.

Cyst aspiration combined with intracavitary phosphorus-32 (32 P) instillation is an alternative to traditional surgical resection (see video below). Good long-term control of tumor growth has been demonstrated; however, a tumor with significant solid components is not likely to respond to32 P.[30] Intracystic chemotherapy with bleomycin has also been tried, with some success in short-term reduction of cyst size.[31] Intracavitary therapy requires that an Ommaya reservoir be placed into the cyst. Care needs to be taken that the catheter tip openings are in the cyst itself and that there is no spillage of cyst contents or injected material outside the cyst wall.

Dissection of craniopharyngioma cyst with aspiration.


In an attempt to balance the advantages of an aggressive surgical resection against the risk of significant morbidity, a preoperative grading system (for children) has been proposed. This system considers the extent of invasion of the hypothalamus by the tumor and is as follows:[32]

  • Type 0: The tumor represents no hypothalamic involvement.
  • Type 1: The tumor distorts or elevates the hypothalamus, but the latter is still visible.
  • Type 2: The hypothalamus is no longer visible.

Consequently, some proposed that a gross total resection be attempted in type 0 and type 1 tumors and that a subtotal resection be attempted in a type 2 tumor, leaving only the hypothalamic component. Although this grading system was developed in a pediatric population, applying it to an adult population is certainly feasible. Some evidence exists, however, that the craniopharyngiomas that arise in adults are less likely to invade the hypothalamus.

A newer classification system proposed by Kassam et al uses a scheme that divides tumors according to their suprasellar extension, based upon the endoscopic expanded endonasal approach (EEA), and is as follows:[29]

  • Type I - Preinfundibular
  • Type II - Transinfundibular (extending into the stalk)
  • Type III - Retroinfundibular, extending behind the gland and stalk, and has 2 subdivisions (IIIa, extending into the third ventricle; and IIIb, extending into the interpeduncular cistern)
  • Type IV - Isolated to the third ventricle and/or optic recess and is not accessible via an endonasal approach

Radiation therapy

Radiation is indicated in patients who had a subtotal resection of craniopharyngioma or with recurrence of the disease. Types of radiation therapy include stereotactic radiosurgery (SRS) and fractionated external beam radiation therapy.

Stereotactic techniques (SRS) are based on localization of the target through stereotactic frame coordinates (attached to the head as in Gamma Knife) or non–frame-based techniques (CyberKnife). Small tumors can be treated with a single fraction of radiation that delivers a high dose of radiation with rapid falloff to minimize the dose to surrounding structures. A larger target volume or proximity to the optic nerve and chiasm may require use of fractionated SRS techniques designed to minimize damage to healthy structures. The dose delivered is usually limited by the optic chiasm, which ideally should receive less than 10 Gy.

External beam radiation therapy uses 3-dimensional planning to deliver radiation with a margin around the tumor. Up to 30 fractions may be used to deliver an effective total dose while keeping daily doses low. Recurrence of tumor is higher when total dose is less than 54 Gy, while complications increase with doses greater than 62 Gy.[14, 33, 34]

Recent data support the concept of subtotal resection followed by radiation therapy as an effective therapy equal in outcome to gross total resection but with fewer complications.[35]


Preoperative Details

Preoperative workup includes an endocrinologic evaluation, particularly to exclude hypoadrenalism and hypothyroidism, both of which increase surgical mortality rates. Dexamethasone may be started prior to surgery to decrease edema.[36]


Intraoperative Details

Successful transsphenoidal resection of a craniopharyngioma requires a generous removal of the contents of the sella turcica. Adequate suprasellar decompression occurs when the arachnoid membrane that surrounds the tumor descends into the operative field. Cerebrospinal fluid (CSF) leakage occurs if the arachnoid is disrupted.

The goal of a craniotomy is gross total removal of the tumor with preservation of the optic apparatus and pituitary stalk. Understanding the anatomy in this region is key to accomplishing this goal. The optic chiasm is nearly always elevated, and the pituitary stalk is usually displaced posteriorly. The stalk may be identified by the striate pattern of portal vessels along its surface. The lamina terminalis may need to be opened for access into the third ventricle. The goal of tumor removal must not outweigh the need for preservation of neural structures; therefore, leaving undisturbed a tumor that is densely adherent to the optic apparatus, anterior cerebral artery, or hypothalamus is advisable.

In general, because long-term tumor control is excellent with radiation therapy following subtotal tumor removal, a conservative approach to tumor resection is usually advised.[37] In some patients, however, a good cleavage plane exists between tumor and brain, and a true complete resection can be accomplished. Surgical judgment is crucial in the assessment of this possibility.



Performing a full postoperative endocrine evaluation as well as repeated imaging studies is advisable. MRI scans are typically obtained immediately postoperatively (within 48 h), at approximately 3 months, and annually thereafter. Long-term follow-up also includes visual-field and pituitary hormone testing.



The most common complications are related to injury of the adjacent neural structures. Vision may worsen because of unavoidable optic apparatus manipulation.[38]

Postoperatively, many patients demonstrate hypopituitarism. In order to offset this, they are usually given physiologic doses of hydrocortisone as well as a dexamethasone taper to decrease the edema associated with the surgical approach.

Diabetes insipidus may develop and may require treatment with fluid replacement and, occasionally, vasopressin or its synthetic analogue, desmopressin. Some patients have diabetes insipidus as well as disruption of their thirst sensation. These patients pose a difficult management problem and are at high risk for developing hypernatremia. Injuries to the hypothalamus can cause other behavioral changes, including caloric balance disturbance, memory disturbance, and changes in affective behavior.

In rare cases, development of radiation-induced gliomas may occur. This long-term complication has a latency period of greater than 10 years, frequently involves the temporal lobe, and has been predominantly reported in patients who underwent conventional fractionated radiotherapy in their childhood.[39]


Outcome and Prognosis

Total resection is the best chance for cure, although some series have reported good results with subtotal resection and fractionated radiation therapy. Small residual tumor, confirmed on postoperative MRI, is generally treated with external beam radiotherapy; however, stereotactic radiosurgery has been used. The use of proton beam radiotherapy for residual disease is currently being investigated. Although the amount of radiation is limited by the proximity to the optic chiasm, good long-term results are now being reported after radiosurgery.[40, 41, 42, 43, 44]

Adverse effects of radiation therapy include endocrine dysfunction, optic neuritis, dementia, and radiation necrosis. In addition, radiation can induce tumors such as meningiomas, sarcomas, and gliomas. In pediatric cases, radiation is postponed to minimize its effects on intelligence quotient and growth. Survival rates for patients with surgery and radiation are better than with surgery alone because radiation helps deter regrowth when residual tumor is present.[45]

Brachytherapy has also been used to treat cystic craniopharyngiomas. Radioisotopes are placed into the cystic portions of the craniopharyngioma. Phosphorus-32 (32 P), colloidal gold-198, colloidal yttrium-91, and bleomycin have all been used. Bleomycin causes shrinkage of the cyst but is highly toxic to neural structures.

In a review of brachytherapy for craniopharyngiomas, Van den Berge followed 31 patients for an average of 41 months.[46] Twenty-nine percent showed improvement of visual acuity, while 13% had stable visual acuity, and 58% deteriorated. Similarly, 28% showed improvement of their visual fields, with 20% showing no change, and 52% deteriorating.

Mortality and morbidity

Overall, the surgical mortality rate is less than 5%, mostly from hypothalamic injury. Bilateral hypothalamic injuries lead to hyperthermia and somnolence. The 10-year survival rate, excluding non–tumor-related deaths, is 90%.[10]

The recurrence of craniopharyngiomas is reported to be up to 24% with approximately a 7-year follow-up. The main risk factor for recurrence is the presence of the residual tumor. Tumor recurrence is higher in the first 3 years after surgery.[47]

In patients with gross total removal of a craniopharyngioma, the 5-year recurrence-free rate is 84.9%, compared to 48.3% in patients with subtotal removal.[47, 48] Morbidity and mortality rates are higher with recurrence and mainly present as visual deficits, endocrine abnormalities, hypothalamic injury, and neurocognitive and neurobehavioral deficits.[48] The visual impairment can be caused by direct damage during surgery or from a daily dose of radiation greater than 2 Gy. The cumulative probability for visual deficits after surgery/radiation is reported to be 36-48% with a 10-year follow-up[48, 49] .

Endocrine abnormalities are commonly seen in postoperative patients with craniopharyngioma. It presents as hypopituitarism and is reported with deficiencies of at least 3 pituitary hormones in 54-100%.[48, 49] Preoperative endocrine deficits do not improve after the surgery, although patients with diabetes insipidus may improve.[48] Hypothalamic dysfunction after the surgery may present as obesity because of hyperphagia, water balance impairment, loss of temperature control, sleep disorders, and neurocognitive disorders. Hypothalamic damage may result from tumor invasion, direct surgical damage from the resection of adherent tumor, tumor recurrence, and radiation.[48, 50]

Hoffman followed 50 children with craniopharyngiomas.[23] In his 1992 report, 90% had total excision, and tumor recurred in 34%. Of all 50 children, 56% were leading normal or nearly normal lives, often requiring endocrine replacement. Twenty-four percent were able to function reasonably well and to attend school despite intellectual, visual, or weight problems; 8% were significantly handicapped; and 6% died. Effenterre et al reported that failure to achieve an independent living function with poor integration and performance at work or school is seen in 16% of adults and 26% of children.[48, 51] The data from literature show the importance of preoperative planning with a reasonable decision in terms of maximal safe tumor resection and the avoidance of complications.


Future and Controversies

The largest divide in the treatment of craniopharyngiomas regards whether to perform a gross total excision or perform a subtotal resection followed by radiation therapy. Retrospective series support both philosophies. Surgical judgment must temper the enthusiasm for gross total removal at all costs. The use of 3-dimensional conformal radiation treatment (3D CRT), stereotactic radiosurgery (SRS), stereotactic radiotherapy (SRT), and intensity-modulated radiation therapy (IMRT) will further allow treatment of small tumor residua with little risk of neurologic deficit. The development of endoscopic techniques has placed greater emphasis on minimally invasive approaches, but this should not detract from surgical techniques that the surgeon feels most comfortable using.

Contributor Information and Disclosures

Lawrence S Chin, MD, FACS Robert B and Molly G King Endowed Professor and Chair, Department of Neurosurgery, State University of New York Upstate Medical University

Lawrence S Chin, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Association for Cancer Research, Children's Oncology Group, Society for Neuro-Oncology, Congress of Neurological Surgeons, American Association of Neurological Surgeons, American College of Surgeons, Phi Beta Kappa

Disclosure: Nothing to disclose.


Mayur Jayarao, MD, MSc Resident Physician, Department of Neurosurgery, University of Missouri-Columbia School of Medicine

Mayur Jayarao, MD, MSc is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, American Medical Association, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Gentian Toshkezi, MD Resident Physician, Department of Neurosurgery, State University of New York Upstate Medical Center

Gentian Toshkezi, MD is a member of the following medical societies: Congress of Neurological Surgeons, American Academy of Neurological Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ryszard M Pluta, MD, PhD Associate Professor, Neurosurgical Department Medical Research Center, Polish Academy of Sciences, Poland; Clinical Staff Scientist, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH); Fishbein Fellow, JAMA

Ryszard M Pluta, MD, PhD is a member of the following medical societies: Polish Society of Neurosurgeons, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Brian H Kopell, MD Associate Professor, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai

Brian H Kopell, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, International Parkinson and Movement Disorder Society, Congress of Neurological Surgeons, American Society for Stereotactic and Functional Neurosurgery, North American Neuromodulation Society

Disclosure: Received consulting fee from Medtronic for consulting; Received consulting fee from St Jude Neuromodulation for consulting; Received consulting fee from MRI Interventions for consulting.

Additional Contributors

Paul L Penar, MD, FACS Professor, Department of Surgery, Division of Neurosurgery, Director, Functional Neurosurgery and Radiosurgery Programs, University of Vermont College of Medicine

Paul L Penar, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, World Society for Stereotactic and Functional Neurosurgery, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

  1. Pascual JM, Prieto R, Castro-Dufourny I, Carrasco R, Strauss S, Barrios L. Development of intracranial approaches for craniopharyngiomas: an analysis of the first 160 historical procedures. Neurosurg Focus. 2014 Apr. 36(4):E13. [Medline]. [Full Text].

  2. Garnett MR, Puget S, Grill J, Sainte-Rose C. Craniopharyngioma. Orphanet J Rare Dis. 2007 Apr 10. 2:18. [Medline]. [Full Text].

  3. Hoffman HJ. Craniopharyngiomas. Can J Neurol Sci. 1985 Nov. 12(4):348-52. [Medline].

  4. Karavitaki N, Cudlip S, Adams CB, Wass JA. Craniopharyngiomas. Endocr Rev. 2006 Jun. 27(4):371-97. [Medline]. [Full Text].

  5. Rutka JT. Craniopharyngioma. J Neurosurg. 2002 Jul. 97(1):1-2; discussion 2. [Medline]. [Full Text].

  6. Stiller CA, Nectoux J. International incidence of childhood brain and spinal tumours. Int J Epidemiol. 1994 Jun. 23(3):458-64. [Medline].

  7. Izuora GI, Ikerionwu S, Saddeqi N, Iloeje SO. Childhood intracranial neoplasms Enugu, Nigeria. West Afr J Med. 1989 Jul-Sep. 8(3):171-4. [Medline].

  8. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM. The descriptive epidemiology of craniopharyngioma. Neurosurg Focus. 1997 Dec 15. 3(6):e1. [Medline].

  9. Jane JA Jr, Laws ER. Craniopharyngioma. Pituitary. 2006. 9(4):323-6. [Medline].

  10. Garre ML, Cama A. Craniopharyngioma: modern concepts in pathogenesis and treatment. Curr Opin Pediatr. 2007 Aug. 19(4):471-9. [Medline].

  11. Combelles G, Ythier H, Wemeau JL, Cappoen JP, Delandsheer JM, Christiaens JL. [Craniopharyngioma in the same family]. Neurochirurgie. 1984. 30(5):347-9. [Medline].

  12. Sanford RA, Muhlbauer MS. Craniopharyngioma in children. Neurol Clin. 1991 May. 9(2):453-65. [Medline].

  13. Crotty TB, Scheithauer BW, Young WF, et al. Papillary craniopharyngioma: a clinicopathological study of 48 cases. J Neurosurg. 1995 Aug. 83(2):206-14. [Medline].

  14. Regine WF, Kramer S. Pediatric craniopharyngiomas: long term results of combined treatment with surgery and radiation. Int J Radiat Oncol Biol Phys. 1992. 24(4):611-7. [Medline].

  15. Fukushima T, Hirakawa K, Kimura M, Tomonaga M. Intraventricular craniopharyngioma: its characteristics in magnetic resonance imaging and successful total removal. Surg Neurol. 1990 Jan. 33(1):22-7. [Medline].

  16. Jagannathan J, Dumont AS, Jane JA Jr, Laws ER Jr. Pediatric sellar tumors: diagnostic procedures and management. Neurosurg Focus. 2005 Jun 15. 18(6A):E6. [Medline].

  17. Nelson GA, Bastian FO, Schlitt M, White RL. Malignant transformation in craniopharyngioma. Neurosurgery. 1988 Feb. 22(2):427-9. [Medline].

  18. Saeki N, Nagai Y, Matsuura I, et al. Histologic characteristics of normal perivascular spaces along the optic tract: new pathogenetic mechanism for edema in tumors in the pituitary region. AJNR Am J Neuroradiol. 2004 Aug. 25(7):1218-22. [Medline].

  19. Baskin DS, Wilson CB. Surgical management of craniopharyngiomas. A review of 74 cases. J Neurosurg. 1986 Jul. 65(1):22-7. [Medline].

  20. Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 2004 Sep. 55(3):539-47; discussion 547-50. [Medline].

  21. Dhellemmes P, Vinchon M. Radical resection for craniopharyngiomas in children: surgical technique and clinical results. J Pediatr Endocrinol Metab. 2006 Apr. 19 Suppl 1:329-35. [Medline].

  22. Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M. Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg. 1999 Feb. 90(2):237-50. [Medline].

  23. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI. Aggressive surgical management of craniopharyngiomas in children. J Neurosurg. 1992 Jan. 76(1):47-52. [Medline].

  24. Norris JS, Pavaresh M, Afshar F. Primary transsphenoidal microsurgery in the treatment of craniopharyngiomas. Br J Neurosurg. 1998 Aug. 12(4):305-12. [Medline].

  25. Tomita T, Bowman RM. Craniopharyngiomas in children: surgical experience at Children's Memorial Hospital. Childs Nerv Syst. 2005 Aug. 21(8-9):729-46. [Medline].

  26. Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P. Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg. 1990 Jul. 73(1):3-11. [Medline].

  27. Leng LZ, Greenfield JP, Souweidane MM, Anand VK, Schwartz TH. Endoscopic, endonasal resection of craniopharyngiomas: analysis of outcome including extent of resection, cerebrospinal fluid leak, return to preoperative productivity, and body mass index. Neurosurgery. 2012 Jan. 70(1):110-23; discussion 123-4. [Medline].

  28. Kaptain GJ, Vincent DA, Sheehan JP, Laws ER Jr. Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery. 2001 Jul. 49(1):94-100; discussion 100-1. [Medline].

  29. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg. 2008 Apr. 108(4):715-28. [Medline].

  30. Hasegawa T, Kondziolka D, Hadjipanayis CG, Lunsford LD. Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery. 2004 Apr. 54(4):813-20; discussion 820-2. [Medline].

  31. Steinbok P, Hukin J. Intracystic treatments for craniopharyngioma. Neurosurg Focus. 2010 Apr. 28(4):E13. [Medline].

  32. Puget S, Garnett M, Wray A, et al. Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg. 2007 Jan. 106(1 Suppl):3-12. [Medline].

  33. Cavazzuti V, Fischer EG, Welch K, Belli JA, Winston KR. Neurological and psychophysiological sequelae following different treatments of craniopharyngioma in children. J Neurosurg. 1983 Sep. 59(3):409-17. [Medline].

  34. Masson-Cote L, Masucci GL, Atenafu EG, et al. Long-term outcomes for adult craniopharyngioma following radiation therapy. Acta Oncol. 2013 Jan. 52(1):153-8. [Medline].

  35. Schoenfeld A, Pekmezci M, Barnes MJ, et al. The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neurooncol. 2012 May. 108(1):133-9. [Medline].

  36. Hopper N, Albanese A, Ghirardello S, Maghnie M. The pre-operative endocrine assessment of craniopharyngiomas. J Pediatr Endocrinol Metab. 2006 Apr. 19 Suppl 1:325-7. [Medline].

  37. Fischer EG, Welch K, Shillito J Jr, Winston KR, Tarbell NJ. Craniopharyngiomas in children. Long-term effects of conservative surgical procedures combined with radiation therapy. J Neurosurg. 1990 Oct. 73(4):534-40. [Medline].

  38. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E. Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol. 2004. 46:220-229.

  39. Enchev Y, Ferdinandov D, Kounin G, Encheva E, Bussarsky V. Radiation-induced gliomas following radiotherapy for craniopharyngiomas: a case report and review of the literature. Clin Neurol Neurosurg. 2009 Sep. 111(7):591-6. [Medline].

  40. Habrand JL, Ganry O, Couanet D, et al. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys. 1999 May 1. 44(2):255-63. [Medline].

  41. Kalapurakal JA. Radiation therapy in the management of pediatric craniopharyngiomas--a review. Childs Nerv Syst. 2005 Aug. 21(8-9):808-16. [Medline].

  42. Laws ER Jr, Vance ML. Radiosurgery for pituitary tumors and craniopharyngiomas. Neurosurg Clin N Am. 1999 Apr. 10(2):327-36. [Medline].

  43. Vernet O, Montes JL, Farmer JP, Blundell JE, Bertrand G, Freeman CR. Long term results of multimodality treatment of craniopharyngioma in children. J Clin Neurosci. 1999 May. 6(3):199-203. [Medline].

  44. Wara WM, Sneed PK, Larson DA. The role of radiation therapy in the treatment of craniopharyngioma. Pediatr Neurosurg. 1994. 21 Suppl 1:98-100. [Medline].

  45. Paulino AC, Fowler BZ. Secondary neoplasms after radiotherapy for a childhood solid tumor. Pediatr Hematol Oncol. 2005 Mar. 22(2):89-101. [Medline].

  46. Van den Berge JH, Blaauw G, Breeman WA, Rahmy A, Wijngaarde R. Intracavitary brachytherapy of cystic craniopharyngiomas. J Neurosurg. 1992 Oct. 77(4):545-50. [Medline].

  47. Mortini P, Losa M, Pozzobon G, et al. Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. J Neurosurg. 2011 May. 114(5):1350-9. [Medline]. [Full Text].

  48. Mortini P, Gagliardi F, Boari N, Losa M. Surgical strategies and modern therapeutic options in the treatment of craniopharyngiomas. Crit Rev Oncol Hematol. 2013 Dec. 88(3):514-29. [Medline]. [Full Text].

  49. Karavitaki N, Brufani C, Warner JT, et al. Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf). 2005 Apr. 62(4):397-409. [Medline]. [Full Text].

  50. De Vile CJ, Grant DB, Kendall BE, et al. Management of childhood craniopharyngioma: can the morbidity of radical surgery be predicted?. J Neurosurg. 1996 Jul. 85(1):73-81. [Medline]. [Full Text].

  51. Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg. 2002 Jul. 97(1):3-11. [Medline]. [Full Text].

  52. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM. The descriptive epidemiology of craniopharyngioma. Neurosurg Focus. 1997 Dec 15. 3(6):e1. [Medline].

  53. Byrne MN, Sessions DG. Nasopharyngeal craniopharyngioma. Case report and literature review. Ann Otol Rhinol Laryngol. 1990 Aug. 99(8):633-9. [Medline].

  54. Cushing H. The craniopharyngioma. Intracranial tumours. London: Bailliere, Tindall and Cox; 1932. 93-98.

  55. Hayward R. The present and future management of childhood craniopharyngioma. Childs Nerv Syst. 1999 Nov. 15(11-12):764-9. [Medline].

  56. Karavitaki N, Brufani C, Warner JT, Adams CB, Richards P, Ansorge O. Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf). 2005 Apr. 62(4):397-409. [Medline].

  57. Kobayashi T, Kida Y, Hasegawa T. Long-term results of gamma knife surgery for craniopharyngioma. Neurosurg Focus. 2003 May 15. 14(5):e13. [Medline].

  58. Lafferty AR, Chrousos GP. Pituitary tumors in children and adolescents. J Clin Endocrinol Metab. 1999 Dec. 84(12):4317-23. [Medline].

  59. Sano K, Mayanagi Y, Sekino H, Ogashiwa M, Ishijima B. Results of timulation and destruction of the posterior hypothalamus in man. J Neurosurg. 1970 Dec. 33(6):689-707. [Medline].

  60. Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D. Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery. 1994 Dec. 35(6):1001-10; discussion 1010-1. [Medline].

  61. Zenker FA. Enorm Cystenbildung im Gehirn, vom Hiranhang ausgehend. Arch Pathol Anat Physiol Klin Med. 1857. 2:454-466.

Coronal MRI shows a craniopharyngioma in the suprasellar space that causes compression of the optic nerves and chiasm.
Sagittal MRI shows a cystic craniopharyngioma in the suprasellar space with extension into the third ventricle.
Axial MRI shows a craniopharyngioma cyst that contains proteinaceous fluid in the third ventricle. The cyst fluid appears hyperintense.
Dissection of craniopharyngioma cyst with aspiration.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.