eMedicine Specialties > Radiology > Brain/Spine

Craniopharyngioma: Follow-up

Author: Jeffrey R Wasserman, DO, Diagnostic Radiologist, Manatee Memorial Hospital and Lakewood Ranch Medical Center
Coauthor(s): Robert A Koenigsberg, DO, MSc, FAOCR, Professor, Director of Neuroradiology, Program Director, Diagnostic Radiology and Neuroradiology Training Programs, Department of Radiology, Hahnemann University Hospital, Drexel University College of Medicine; Kiran Batra, MD, DNB, Neuroradiology Fellow, Radiology Resident, Drexel University College of Medicine; Christopher P Gange Jr, MA, Drexel University College of Medicine
Contributor Information and Disclosures

Updated: Jun 11, 2008

Intervention

Primary treatments include radical surgery or limited surgery, such as subtotal resection and radiation therapy. Surgery has been associated with a high risk of hypothalamic injury and visual impairment. Some success has been observed with intracystic chemotherapeutic (bleomycin) injection, which is effective in treating the cystic component; it is also used as an adjuvant therapy and in stereotactic radiotherapy.5,7,15,16,20,24,25,26,27

Medicolegal Pitfalls

  • Failure to make the diagnosis is a pitfall because tumor calcifications on CT may be misinterpreted as enhancing aneurysms, and correlation with cerebral angiographic findings may be needed to differentiate the 2 entities.
  • In addition, calcifications appear as signal voids on MRI and can be misinterpreted as aneurysms. MRA should be performed in questionable cases.

See also the Medscape topic Medical Malpractice and Legal Issues.

 


More on Craniopharyngioma

Overview: Craniopharyngioma
Imaging: Craniopharyngioma
Follow-up: Craniopharyngioma
Multimedia: Craniopharyngioma
References
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References

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  2. Brant W, Helms C. Fundamentals of Diagnostic Radiology. 1994: 130-2.

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

  4. 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].

  5. Garnett MR, Puget S, Grill J, Sainte-Rose C. Craniopharyngioma. Orphanet J Rare Dis. 2007;2:18. [Medline].

  6. Saeki N, Nagai Y, Matsuura I. 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. Aug 2004;25(7):1218-22. [Medline].

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

  8. Hetelekidis S, Barnes PD, Tao ML. 20-year experience in childhood craniopharyngioma. Int J Radiat Oncol Biol Phys. Sep 30 1993;27(2):189-95. [Medline].

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

  10. Jeong IH, Lee JK, Moon KS, Joo SP, Kwak HJ, Kim TS. Ectopic recurrence of craniopharyngioma: a case report and review of the literature. J Neurooncol. Sep 2006;79(2):191-5. [Medline].

  11. Hofman R, Rosingh HJ. Unilateral hearing loss as primary symptom of craniopharyngioma in a six-year-old girl. J Laryngol Otol. Mar 2008;122(3):e10. [Medline].

  12. Delman BN, Fatterpekar GM, Law M, Naidich TP. Neuroimaging for the pediatric endocrinologist. Pediatr Endocrinol Rev. Feb 2008;5 Suppl 2:708-19. [Medline].

  13. Curran JG, O'Connor E. Imaging of craniopharyngioma. Childs Nerv Syst. Aug 2005;21(8-9):635-9. [Medline].

  14. Harwood-Nash DC. Neuroimaging of childhood craniopharyngioma. Pediatr Neurosurg. 1994;21 (suppl 1):2-10. [Medline].

  15. Srinivasan S, Ogle GD, Garnett SP. Features of the metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab. 2004;Jan;89(1):81-6. [Medline].

  16. Kolen ER, Horvai A, Perry V. Congenital craniopharyngioma: a role for imaging in the prenatal diagnosis and treatment of an uncommon tumor. Fetal Diagn Ther. ): 2003;Jul-Aug;18(4):270-4. [Medline].

  17. Edgar MA, Rosenblum MK. The differential diagnosis of central nervous system tumors: a critical examination of some recent immunohistochemical applications. Arch Pathol Lab Med. Mar 2008;132(3):500-9. [Medline].

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

  19. Holscher T, Draganski B, Postert T. Brain perfusion imaging of a craniopharyngioma by transcranial duplexsonography. J Neuroimaging. 2003;Oct;13(4):303-6. [Medline].

  20. Habrand JL, Ganry O, Couanet D. 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. May 1 1999;44(2):255-63. [Medline].

  21. Osborn AG. Diagnostic Neuroradiology. St Louis: Mosby-Year Book;1994:654-6.

  22. Atlas SW, ed. Magnetic Resonance Imaging of the Brain and Spine. 2nd ed. Lippincott-Raven;1995:894-8.

  23. Choi SH, Kwon BJ, Na DG, Kim JH, Han MH, Chang KH. Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: differentiation using MRI. Clin Radiol. May 2007;62(5):453-62. [Medline].

  24. Stamm AC, Vellutini E, Harvey RJ, Nogeira JF Jr, Herman DR. Endoscopic Transnasal Craniotomy and the Resection of Craniopharyngioma. Laryngoscope. Apr 24 2008;[Medline].

  25. Lin LL, El Naqa I, Leonard JR, Park TS, Hollander AS, Michalski JM, et al. Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatrics. Feb 2008;1(2):126-30. [Medline].

  26. Kim SD, Park JY, Park J, Lee JB, Kim SH, Lim DJ. Radiological findings following postsurgical intratumoral bleomycin injection for cystic craniopharyngioma. Clin Neurol Neurosurg. Apr 2007;109(3):236-41. [Medline].

  27. Hasegawa T, Kondziolka D, Hadjipanayis CG. Management of cystic craniopharyngiomas with phosphorus-32 intracavitaryirradiation. Neurosurgery. 2004;Apr;54(4):813-20. [Medline].

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Further Reading

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Keywords

Rathke pouch tumor, craniopharyngeal duct tumor, hemangioblastoma, ameloblastoma, adamantinoma, dysodontogenic epithelial tumor, adamantinomatous tumor, papillary tumor, sellar craniopharyngioma, prechiasmatic craniopharyngioma, retrochiasmatic craniopharyngioma

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Contributor Information and Disclosures

Author

Jeffrey R Wasserman, DO, Diagnostic Radiologist, Manatee Memorial Hospital and Lakewood Ranch Medical Center
Jeffrey R Wasserman, DO is a member of the following medical societies: American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Koenigsberg, DO, MSc, FAOCR, Professor, Director of Neuroradiology, Program Director, Diagnostic Radiology and Neuroradiology Training Programs, Department of Radiology, Hahnemann University Hospital, Drexel University College of Medicine
Robert A Koenigsberg, DO, MSc, FAOCR is a member of the following medical societies: American Osteopathic Association, American Society of Neuroradiology, Radiological Society of North America, and Society of NeuroInterventional Surgery
Disclosure: Nothing to disclose.

Kiran Batra, MD, DNB, Neuroradiology Fellow, Radiology Resident, Drexel University College of Medicine
Kiran Batra, MD, DNB is a member of the following medical societies: American Roentgen Ray Society, Pennsylvania Radiological Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Christopher P Gange Jr, MA, Drexel University College of Medicine
Disclosure: Nothing to disclose.

Medical Editor

Mahesh R Patel, MD, Chief, MRI, Department of Diagnostic Imaging, Santa Clara Valley Medial Center
Mahesh R Patel, MD is a member of the following medical societies: American Roentgen Ray Society, American Society of Neuroradiology, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Robert L DeLaPaz, MD, Director, Professor, Department of Radiology, Division of Neuroradiology, Columbia University
Robert L DeLaPaz, MD is a member of the following medical societies: American Society of Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

James G Smirniotopoulos, MD, Professor of Radiology, Neurology, and Biomedical Informatics, Chairman, Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences
James G Smirniotopoulos, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, American Society of Head and Neck Radiology, American Society of Neuroradiology, American Society of Pediatric Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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