Radiological and endocrinological evaluations with grading of hypothalamic perifocal edema caused by craniopharyngiomas

Hayashi, Yasuhiko; Sasagawa, Yasuo; Oishi, Masahiro; Misaki, Kouichi; Kozaka, Kazuto; Tachibana, Osamu; Nakada, Mitsutoshi

doi:10.1007/s11102-019-00945-z

Cited by 6 publications

(3 citation statements)

References 34 publications

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“…Only two specific surgical series dealing with PCPs were found [ 27 , 28 ]. The other studies were precedent literature reviews about a related topic [ 1 , 2 , 3 , 10 , 12 , 13 , 14 , 29 , 30 , 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Van Gompel et al identified both hypothalamic changes on MRI T2WI and the irregular enhancement as pre-operative predictors of higher-grade hypothalamic involvement [ 20 ]. Hayashi et al reported that the degree of the extent of the peritumoral hypothalamic edema on coronal FLAIR and T2WI MRI images could be an index of the pre- and postoperative functional outcome in adult patients [ 22 , 32 , 33 ]. Indeed, the authors found that patients with focal hypothalamic edema in MRI (group B) or extensive edema in the optic tract and internal capsule (group C) presented a worse outcome than those without edema (group A).…”

Section: Discussionmentioning

confidence: 99%

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Current Advances in Papillary Craniopharyngioma: State-Of-The-Art Therapies and Overview of the Literature

et al. 2023

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Craniopharyngiomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior due to their high rate of recurrence and long-term morbidity. Craniopharyngiomas are classically distinguished into two histological types (adamantinomatous and papillary), which have been recently considered by the WHO classification of CNS tumors as two independent entities, due to different epidemiological, radiological, histopathological, and genetic patterns. With regard to papillary craniopharyngioma, a BRAF V600 mutation is detected in 95% of cases. This genetic feature is opening new frontiers in the treatment of these tumors using an adjuvant or, in selected cases, a neo-adjuvant approach. In this article, we present an overview of the more recent literature, focusing on the specificities and the role of oncological treatment in the management of papillary craniopharyngiomas. Based on our research and experience, we strongly suggest a multimodal approach combining clinical, endocrinological, radiological, histological, and oncological findings in both preoperative workup and postoperative follow up to define a roadmap integrating every aspect of this challenging condition.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Current Advances in Papillary Craniopharyngioma: State-Of-The-Art Therapies and Overview of the Literature

et al. 2023

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“…Meanwhile, it is well understood that the HPA plays a pivotal role in maintaining pituitary function. However, when evaluating endocrinological outcomes following surgery or addressing the issue that whether the pituitary stalk infiltrated by tumors can be sacrificed to achieve radical resection, previous studies only analyzed the effects of either the injury of the pituitary stalk ( 7 – 11 ) or the injury of the hypothalamus ( 12 , 13 ) or the injury of the pituitary ( 14 ) on pituitary function, not mentioning any information about whether or not the other part of the HPA was injured. Given that the combined injury of the HPA is often encountered in patients with surgically treated CP due to different topographical characteristics of tumors, it is necessary to elucidate the impacts of combined injuries of the HPA on pituitary function, which is very helpful to comprehensively evaluate the impacts of the manipulation of the HPA on pituitary function and further tailor individual surgical strategies.…”

Section: Introductionmentioning

confidence: 99%

Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma

Yang

et al. 2022

Front. Oncol.

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ObjectivePostoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus–pituitary axis (HPA) to predict hypopituitarism 1 year after surgery.MethodsCraniopharyngioma patients undergoing initial endoscopic endonasal surgery between December 2012 and March 2021 in our center were retrospectively reviewed, and injury types of the HPA were categorized according to intraoperative endoscopic observation. Included patients were randomly divided into a training group and a validation group. Nomograms were established based on the results of multivariate logistic analysis. The predictive performance of the nomograms was evaluated in the training and validation groups.ResultsA total of 183 patients with craniopharyngioma were enrolled, and seven injury types of the HPA were summarized. Relative to intact HPA, exclusive hypothalamus injury significantly increased the risk of anterior (OR, 194.174; 95% CI, 21.311–1769.253; p < 0.001) and posterior pituitary dysfunction (OR, 31.393; 95% CI, 6.319–155.964; p < 0.001) 1 year after surgery, while exclusively sacrificing stalk infiltrated by tumors did not significantly increase the risk of anterior (OR, 5.633; 95% CI, 0.753–42.133; p = 0.092) and posterior pituitary dysfunction (OR, 1.580; 95% CI, 0.257–9.707; p = 0.621) 1 year after surgery. In the training group, the AUCs of nomograms predicting anterior and posterior pituitary dysfunction 1 year after surgery were 0.921 and 0.885, respectively, compared with 0.921 and 0.880 in the validation group.ConclusionsIntact hypothalamus structure is critical in maintaining pituitary function. Moreover, our preliminary study suggests that the pituitary stalk infiltrated by craniopharyngioma could be sacrificed to achieve radical resection, without substantially rendering significantly worse endocrinological efficiency 1 year after surgery. The user-friendly nomograms can be used to predict hypopituitarism 1 year after surgery.

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Pediatric craniopharyngiomas: magnetic resonance imaging assessment for hypothalamus-pituitary axis dysfunction and outcome prediction

Calandrelli,

Pilato,

Massimi

et al. 2023

Pediatr Radiol

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Radiological and endocrinological evaluations with grading of hypothalamic perifocal edema caused by craniopharyngiomas

Cited by 6 publications

References 34 publications

Current Advances in Papillary Craniopharyngioma: State-Of-The-Art Therapies and Overview of the Literature

Current Advances in Papillary Craniopharyngioma: State-Of-The-Art Therapies and Overview of the Literature

Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma

Pediatric craniopharyngiomas: magnetic resonance imaging assessment for hypothalamus-pituitary axis dysfunction and outcome prediction

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