Case
About this case
Operative video: Craniopharyngioma. The background notes below summarise the anatomy, pathology and approach, with published references.
Reference notes
Background
Notes on this case’s cranial location, pathology and surgical approach, with published sources. General education only, not advice for any individual patient.
Pathology
Craniopharyngioma
Craniopharyngiomas are benign (CNS WHO grade 1) but adherent epithelial tumours of the sellar/suprasellar region arising from Rathke-pouch remnants. The 2021 WHO classification treats the two forms as separate tumour types: adamantinomatous (mostly children, CTNNB1-mutant, with cystic “machine-oil” fluid and calcification) and papillary (adults, BRAF V600E-mutant, usually solid and non-calcified). They present with visual loss, hypopituitarism and, in children, growth failure, and attach densely to the hypothalamus and chiasm.
Treatment balances the extent of resection against hypothalamic injury, using endonasal or transcranial approaches, with radiotherapy for residual disease; BRAF/MEK inhibitors are an option for papillary tumours.