Nasopharyngeal Craniopharyngioma

Abstract

Craniopharyngioma is an intracranial tumor that occurs rarely in the infrasellar region. Eight patients with craniopharyngioma located within the nasopharynx have been reported previously. These cases originated in the nasopharynx and involved the sella turcica (6), the sphenoid sinus (1), and the vomer (1). Craniopharyngioma usually originates intracranially. When there is no evidence of sellar involvement, the tumor most likely arises along the path of the craniopharyngeal duct. According to the neurosurgical literature, the optimal treatment consists of total surgical excision. Incomplete tumor removal is supplemented by adjunctive radiotherapy, which has been shown to significantly increase the survival rate. A patient with craniopharyngioma of the nasopharynx and paranasal sinuses who presented with nasal obstruction is reported. Radiographic studies were employed for tumor evaluation, and biopsy was done to establish the histopathologic diagnosis. Treatment included a combination of surgical excision and irradiation.

Recurrent Craniopharyngioma with Nasopharyngeal Extension

“…However, it seems to be difficult to differentiate these two types of nasopharyngeal craniopharyngioma when the tumors are large and extensively located in the spheno-nasopharyngeal area [23]. With a critical review of the literature, 6 cases were considered ectopic craniopharyngioma [2, 4, 6, 8, 9, 12]. Most nasopharyngeal craniopharyngiomas seem to be abnormal extensions from the sella turcica or its vicinity as seen in our patient.…”

“…Very rarely, nasopharyngeal occurrence has been reported. To the best of our knowledge, 27 cases of nasopharyngeal craniopharyngioma have been reported in the literature [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. Among these, 4 were recurrent cases and had initially undergone craniotomy or radiation therapy [11, 19, 20, 21].…”

“…Management is surgical, through a transnasal, transpalatal [9, 19, 24], transrhinoseptal [5, 7], transcranial [11, 25], lateral rhinotomy [2, 4]or infratemporal approach [6], or a combination of these approaches [8, 12]. Earlier methods involved aspiration of a single cyst, evacuation of a multicystic mass or tumor marsupialization [4].…”

“…Earlier methods involved aspiration of a single cyst, evacuation of a multicystic mass or tumor marsupialization [4]. This led to a symptomatic improvement because of a reduction in cystic pressure.…”

“…It is mainly suprasellar, but can be intrasellar or extend into the frontal lobes, the third ventricle or posteriorly along the clivus. Very rarely, nasopharyngeal occurrence has been reported [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. Although the method of managing craniopharyngiomas remains controversial [13, 14], they should ideally be removed completely if the surgery can be performed with acceptable morbidity [15, 16, 17].…”