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Craniopharyngioma: Current Classification, Management, and Future Directions

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Abstract

Craniopharyngioma is one of the most challenging brain tumors, located in sellar/suprasellar region in close proximity to the optic apparatus and hypothalamus. Although histologically low grade, the tumor can be locally aggressive and serve as a source of considerable morbidity due to compression and/or adherence to nearby structures. Due to its unpredictable natural history and long-term sequelae of various treatments, the ideal management of craniopharyngioma has been constantly debated over several generations of neurosurgeons. Many clinical series have advocated for gross total resection (GTR) to reduce the risk of tumor recurrence, while craniopharyngiomas are considered unresectable lesions by other authors and a recommendation for a more conservative neurosurgical approach followed by radiation therapy or intracystic treatment is given. The ongoing debate regarding the use of “aggressive” or “less invasive” surgical approaches has at least the benefit of suggesting that treatment plans should be customized to the individual patient and tumor characteristics. In this way, the maximum, safe neurosurgical procedure can be performed while minimizing untoward patient morbidity.

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Authors and Affiliations

  1. Division of Neurosurgery, Hospital for Sick Children, Toronto, ON, Canada

    Zohreh Habibi & Deya Abu Reesh

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Zohreh Habibi, Deya Abu Reesh & James T. Rutka

  3. Department of Neurosurgery, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Zohreh Habibi

  4. Division of Neurosurgery, The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada

    James T. Rutka

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  1. Department of Neurosurgery, University of Munich Department of Neurosurgery, Munich, Germany

    Jörg-Christian Tonn

  2. Dana-Farber Cancer Institute Center, Harvard University, Boston, USA

    David A. Reardon

  3. SickKids Hospital, University of Toronto, Toronto, ON, Canada

    James T. Rutka

  4. Department of Neurosurgery, University of Hamburg, Hamburg, Germany

    Manfred Westphal

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Habibi, Z., Reesh, D.A., Rutka, J.T. (2019). Craniopharyngioma: Current Classification, Management, and Future Directions. In: Tonn, JC., Reardon, D., Rutka, J., Westphal, M. (eds) Oncology of CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-030-04152-6_30

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