The craniopharyngeal canal reviewed and reinterpreted

Craniopharyngeal Canal and Its Spectrum of Pathology

“…14 To our knowledge, our study is the largest series of CPCs since the advent of cross-sectional imaging. On the basis of quantitative and qualitative features, CPCs can be classified into 3 types: small incidental canals (type 1); medium-sized canals with ectopic pituitary tissue (type 2); and large canals containing cephaloceles (type 3A), tumors (type 3B), or both (type 3C).…”

“…Type 3 large CPCs containing tumors and/or cephaloceles often contain ectopic pituitary tissue within the nasopharynx; thus, care should be taken during surgery to avoid iatrogenic hypopituitarism and/or CSF leak. Compared with the previous division of small benign CPCs 14 or large CPCs with associated nasopharyngeal masses and craniofacial malformations, 4 our classification provides a more nuanced characterization of the CPC with the inclusion of medium-sized type 2 canals and subdivision of large type 3 canals. From our data, a nasopharyngeal mass should raise the suspicion for a type 3 CPC, and pituitary dysfunction may suggest a type 2 or 3 CPC.…”

“…Correct diagnosis may indicate pituitary dysfunction, obviate the need for surgery, and prevent iatrogenic hypopituitarism or CSF leak. CPCs have previously been described as either small 14 (Ͻ1.5 mm diameter) or large 4 with or without mass; however, this binary division does not fully characterize its range. In this retrospective review of 29 patients with CPCs, we use quantitative and qualitative imaging features to provide a new system of classification, which divides the malformation into 3 types that more accurately describe size and associated pathologic appearance: small incidental canals (type 1); medium-sized canals containing ectopic (inferiorly displaced) adenohypophysis (type 2); and large canals with associated cephaloceles (type 3A), tumors of the adenohypophysis and associated embryonic tissues (type 3B), or both (type 3C).…”

Craniopharyngeal duct: a cause of recurrent meningitis

“…6 Currarino et al 7 classified the abnormality on the basis of size: the hypophyseal channel or the small craniopharyngeal canal, which have a maximum width of 15 mm, and the large craniopharyngeal canal or transspehnoidal channel, which are more commonly associated with other craniofacial abnormalities such as encephalocoeles, cleft palate and lips and such. More recently, a classification of the craniopharyngeal duct has been proposed by Abele et al 4 based on the size and spectrum of other associated pathologies (e.g.…”

Recurrent meningitis and persistence of craniopharyngeal canal: Case report

“…This hypothesis is supported by histological studies that describe the presence of normal and tumoral pituitary tissue inside the channel 20 , by case reports of panhypopituitarism following adenoidectomy 8,13,28 , by Erdheim's theories and the case reports of infrasellar or nasopharyngeal craneopharyngiomas associated with this anomaly 3 , and by the presence of trans and intrasphenoidal encephaloceles 22,23,27 or by case reports of intrasphenoidal pituitary tissue in asymptomatic population 13,19 . On the other hand, some authors are opposed to this hypothesis based on anatomical studies that describe as habitual content of the conduit an artery and several small veins (similar to the venae vasis vertebrae) inside a connective tissue, concluding that this so called craniopharyngeal canal represents only the persistence of a vascular channel formed during the osteogenesis of the sphenoid bone 1,15,17,18 .…”