Craniopharyngioma is a tumor that develops near the pituitary gland. Although benign, it requires careful treatment because of its proximity to critical structures such as the optic pathways, hypothalamus and pituitary gland.
What is a craniopharyngioma?
A craniopharyngioma is a tumor arising from embryonic cell remnants related to the development of the pituitary gland, located in and around the sella turcica (the pituitary fossa). It can occur both in childhood and in adults.
Although considered histologically benign, its treatment is complex because of its close relationship with vital structures such as the optic nerves, pituitary gland, hypothalamus and cerebral blood vessels. The tumor is usually composed of solid and cystic parts.
Symptoms
- Visual disturbance and narrowing of the visual field
- Headache, nausea and vomiting
- Weakness and fatigue due to hormone deficiencies
- Growth delay and delayed puberty in children
- Excessive thirst and frequent urination (diabetes insipidus)
- Weight gain, sleep and behavioural changes
Diagnosis
MRI and CT show the structure of the tumor, its cystic parts and calcifications. Eye examination with visual field testing and detailed hormone tests are also part of the diagnostic work-up. Treatment is planned together with endocrinology and ophthalmology.
Treatment Approach
- Surgery: Performed through the nose (endoscopic transsphenoidal surgery) or through a craniotomy, depending on the tumor's location. The aim is to remove as much tumor as possible without harming critical structures and to relieve pressure on the optic pathways.
- Radiotherapy and radiosurgery: May be used for residual or recurrent tumor after surgery. Gamma Knife radiosurgery can be an option for suitable small residual lesions.
- Cyst drainage: For large cystic components, methods such as placing a catheter to drain the cyst may be used.
- Hormone replacement: Hormone deficiencies caused by the disease or its treatment are replaced under endocrinology follow-up.
Long-term regular follow-up continues with MRI, vision and hormone checks.