Malignant Transformation in Craniopharyngiomas

Sofela, Agbolahan; Hettige, Samantha; Curran, Olimpia; Bassi, Sanj

doi:10.1227/neu.0000000000000380

Cited by 47 publications

(23 citation statements)

References 19 publications

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“…Although the exact cause and pathogenesis of such malignant transformation are unknown, previous studies have speculated a likely correlation with radiotherapy. On the other hand, in a review by Sofela AA et al, there was a poor correlation found between malignant transformation and radiotherapy [5]. The present case also showed transformation to malignancy without radiotherapy; thus, we consider that there are other factors contributing to malignant transformation of a craniopharyngioma.…”

Section: Discussioncontrasting

confidence: 66%

“…The World Health Organization (WHO) classifies a craniopharyngioma as a benign grade 1 tumor known for high recurrence and local aggressiveness despite treatment [5]. However, cases with malignant transformation are extremely rare, with the first presented in 1987, for a total of 28 reported cases, of which only 6 noted a malignant craniopharyngioma without radiotherapy [4,[6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

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Malignant Transformation of Craniopharyngioma after Growth Hormone Replacement Therapy

Nishimura¹,

Nakase²,

Nakagawa³

et al. 2020

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Background: We present a rare case of malignant transformation of a craniopharyngioma in a patient who received growth hormone replacement therapy. Case Description: A 43-year-old male came to our department with a headache and visual disturbance and was admitted. Brain magnetic resonance imaging (MRI) revealed a giant tumor in the intra- and suprasellar region compressing the optic chiasma. Using a transcranial pterional approach, the tumor was removed as much as possible, with the residual mass removed later with a trans-sphenoidal approach. The initial histopathological diagnosis was adamantinomatous craniopharyngioma. Decompression of the optic chiasma was achieved and visual function improved, though residual tumor tissue remained in the parasellar region, without regrowth seen for more than 24 years. At the age of 67 years, the patient received growth hormone replacement therapy because of a deficiency, then 2 years later the residual tumor began to grow gradually. Trans-sphenoidal surgery was again performed to remove the growing tumor and histopathology results revealed an adamantinomatous craniopharyngioma with malignant transformation. Stereotactic radiation therapy was performed for the residual mass with a total dose of 60 Gy. Presently, 1 year later the patient has a stable condition, and the tumor remains controlled, while follow-up examinations are continuing. Conclusion: A craniopharyngioma may undergo malignant transformation with continuous exposure to administered growth hormone. Close follow-up and imaging examinations are necessary to detect a change, including tumor growth in such cases.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Malignant Transformation of Craniopharyngioma after Growth Hormone Replacement Therapy

Nishimura¹,

Nakase²,

Nakagawa³

et al. 2020

CRSS

View full text Add to dashboard Cite

show abstract

“…Morphologic criteria of malignancy are not clear. According to the previous literature, at least three of the following features should be present: cellularity and increased nuclear‐cytoplasmic ratio, nuclear pleomorphism and hyperchromatic nuclei, increased mitotic activity or higher Ki67 expression, coagulative necrosis and other histologic features such as solid growth pattern, destruction of basement membrane, infiltrative growth and microvascular proliferation .…”

Section: Discussionmentioning

confidence: 99%