Surgical Treatment of Craniophayngioma<i>Radical Removal by the Transantrosphenoidal Approach</i>

Hamberger, C.‐A.; Hammer, Gianna; Norlén, Gösta; Sjögren, Björn

doi:10.3109/00016486009123151

Cited by 28 publications

(6 citation statements)

References 6 publications

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“…The signs of pituitary dysfunction appear early in the cases in which the tumor expands within the sella. The tumor located at the sphenoid sinus usually presents with headache and cavernous sinus syndrome [6][7][8]11,12,15,17,20,23,24,27 . The craniopharyngiomas located in the nasopharyngeal region usually present with frontal headache, nasal obstruction, epistaxis, nasopharyngeal and/or nasal fossa masses 3,5,9,10,13,15,18,19,22,25,26,29,32,34 .…”

Section: Discussionmentioning

confidence: 99%

“…Infrasellar craniopharyngioma cases had the plain skull x-rays and tomograms that showed sinus opacification, tumor expansion, enlarged sella turcica, cystic lesions, fluid level, bony erosions, and calcifications [6][7][8][9][10][13][14][15][16][17][18][19][20][21][22]27,30 . Computed tomography in the cranial base craniopharyngioma cases reported usually reveals the heterogeneous nature of the tumor with its solid and cystic components, calcification, multicysts, lyctic lesions, irregular enhancement.…”

Section: Discussionmentioning

confidence: 99%

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Infrasellar craniopharyngioma: case report

Falavigna

Kraemer

2001

Arq. Neuro-Psiquiatr.

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-We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. The embryology, clinical features and radiographic investigation of these tumors are discussed.KEY WORDS: craniopharyngioma, sphenoid sinus, skull base tumor.Craniofaringioma infra-selar: relato de caso RESUMO -Relatamos um caso de craniofaringioma infra-selar em uma paciente de 34 anos com sintomas de cefaléia e diplopia. A investigação radiológica com tomografia computadorizada e ressonância magnética de encéfalo demonstrou um tumor heterogêneo localizado no osso esfenoidal e com extensão para o seio etmoidal e sela turcica. Realizada cirurgia pela via transesfenoidal. A ocorrência de craniofaringioma com topografia infra-selar é incomum, havendo relato na literatura de 35 casos. A literatura é revisada, sendo discutidas a embriologia, a apresentação clínica e características radiológicas do tumor. . Occasionally, the tumor can occur without sellar involvement. These tumors rarely extend below the sellar floor into the sphenoid sinus or invade the pharynx and the nasal cavities . The infrasellar craniopharyngioma may then originate anywhere along the tract of the obliterated craniopharyngeal duct, which would include the sphenoid bone, vomer, and nasopharynx 35,36 . In this study we report a case of infrasellar craniopharyngioma with the epicenter situated in the sphenoid sinus and review the 35 other reported cases in the literature of this unusual localization since 1924. PALAVRAS-CHAVE CASEA 34 years-old woman presented with frontal headache with progression of 7 months and diplopia that appeared in the last month. Clinical evaluation revealed left abducens nerve palsy. No signs and symptoms of pituitary dysfunction were evident. The laboratory studies, including hypophyseal function were normal.Coronal computed tomographic (CT) scans after intravenous contrast showed a large sphenoid sinus heterogeneous mass with destruction of the ethmoid sinus and sella turcica (Fig 1). T1-weighted (plain and gadoliniumenhanced 600/11/2 [repetion-time/echo time/excitations]) and T2-weighted (3000/108/1) magnetic resonance showed isointense image (Fig 2). Post-contrast the brightly enhancing, heterogeneous mass was clearly visible in the sphenoid bone (Fig 3). There was extension of the tumor to ethmoid sinus and to the sella turcica. Carotid and vertebral angiography revealed that the tumor was avascular.Sublabial rhinoseptal transsphenoidal surgery was performed. After removal of the anterior wall of the sphenoid sinus, a solid firm mass was filled the sphenous sinus. The circumferential wall of the tumor was...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infrasellar craniopharyngioma: case report

Falavigna

Kraemer

2001

Arq. Neuro-Psiquiatr.

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“…In general, it has been suggested that an enlarged pituitary fossa is a prerequisite for transsphenoidal removal of craniopharyngiomas. [4,9,11,14,16,20] However, Honegger, et al, [13] have maintained that this notion should be modified, and they frequently found slight or no enlargement of the pituitary fossa in their series. In our series, we noticed that the pituitary fossa was slightly enlarged in most cases.…”

Section: Discussionmentioning

confidence: 99%

“…[21,23,24] A transsphenoidal approach is chosen when a craniopharyngioma is located either totally or partially within an enlarged sella turcica and has only a limited suprasellar component; several small series concerning this topic have been published. [1,4,[7][8][9]11,13,14,16,20] The anatomical situation makes it more difficult to avoid further damage to the pituitary gland with total tumor removal because the gland has to be incised or dislocated to access the tumor. Since 1971 we have subtotally resected most of the latter-described tumors via a transnasal approach; the senior author has published the results over the period of 1971 to 1984.…”

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confidence: 99%

Recent results of primary transnasal surgery for infradiaphragmatic craniopharyngioma

Abe

Lüdecke

1997

FOC

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Results of primary transnasal surgery were evaluated in 35 patients (18 males and 17 females) with intrasellar and suprasellar craniopharyngiomas treated between 1985 and 1996 when more refined surgical and diagnostic techniques were available. Patients ranged in age from 8 to 72 years (mean 27 years); 14 patients were younger than 18 years of age. The transnasal approach was chosen because of sellar enlargement and presence of infradiaphragmatic tumor. The paramedian portion of the normal pituitary gland was incised vertically to reach a dorsally located tumor in 25 patients. Complete tumor resection was achieved in 15 patients and subtotal removal in 19; in one patient, only aspiration of cyst contents was performed. Tumor regrowth was seen in three patients after subtotal removal; in two, total tumor removal was achieved by a second transnasal surgery, whereas radiotherapy was administered in the other. In a single patient, total tumor removal was achieved by a second transcranial surgery after cyst aspiration. The duration of the clinical follow-up period was at least 1 year. Persistent diabetes insipidus appeared after total tumor resection in five patients. Cerebrospinal fluid leakage occurred in three patients, with two requiring revision. Among 29 patients with preoperatively normal pituitary functions, 20 (69%) were preserved after primary total resection, whereas six (19.4%) of 31 previously disturbed functions were normalized. After subtotal removal including cyst aspiration, 39 (88.6%) of 44 normal functions were preserved, whereas nine (24.3%) of 37 disturbed functions were normalized. The transnasal approach should be the first choice in infradiaphragmatic craniopharyngiomas with sellar enlargement in cases in which the extrasellar portion is mostly cystic and is accessible. The concept of subtotal removal with preservation of pituitary functions, especially when treating craniopharyngioma in children, seems to be justified.

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“…The anterior wall of Rathke's pouch forms both the pars tuberalis and pars distalis of anterior lobe of pituitary, being regarded as the commonest site of origin of craniopharyngioma and rarely also occur along the carniopharyngeal duct which extends from the pharynx up to the floor of sella [2][3][4]. Craniopharyngioma is mostly located usually above the sella floor but extension into sinus is very rare and with unusual [5][6][7][8][9][10][11][12][13][14][15][16][17]. About eleven cases of infrasellar craniopharyngioma are reported in the literature, whose either majority of the chief epicenter or wholly tumour is located in the infrasellar region.…”

Section: Introductionmentioning

confidence: 99%

Craniopharyngioma with infrasellar extension in an eight-year boy: An unusual entity

Satyarthee¹

2017

Surg Rehabil

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Craniopharyngiomas are mostly lactated in the suprasellar region. However, ectopic craniopharyngioma may be rarely located in the infrasellar region. We report an 8-year -old boy, who had large craniopharyngioma predominantly involving sella turcica, sphenoid sinus, ethmoid sinus, and nasal cavity. He presented with progressive visual impairment. He underwent transsphenoidal decompression. He made unremarkable visual recovery following surgery.

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Surgical Treatment of CraniophayngiomaRadical Removal by the Transantrosphenoidal Approach

Cited by 28 publications

References 6 publications

Infrasellar craniopharyngioma: case report

Infrasellar craniopharyngioma: case report

Recent results of primary transnasal surgery for infradiaphragmatic craniopharyngioma

Craniopharyngioma with infrasellar extension in an eight-year boy: An unusual entity

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