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Hypothalamus-referenced classification for craniopharyngiomas: evidence provided by the endoscopic endonasal approach

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References

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Authors and Affiliations

  1. Department of Neurosurgery, La Princesa University Hospital, C/ Diego de León 62, 28006, Madrid, Spain

    José M. Pascual & Ricardo Gil Simoes

  2. Department of Neurosurgery, Virgen de La Salud Hospital, Toledo, Spain

    Ruth Prieto

  3. Department of Endocrinology, Hospital del Sureste, Madrid, Spain

    Ines Castro Dufourny

  4. Department of Neurosurgery, Ramón y Cajal University Hospital, Madrid, Spain

    Rodrigo Carrasco

Authors
  1. José M. Pascual
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  2. Ruth Prieto
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  3. Ines Castro Dufourny
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  4. Ricardo Gil Simoes
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  5. Rodrigo Carrasco
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Corresponding author

Correspondence to José M. Pascual.

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Comments

Paolo Cappabianca, Lugi M. Cavallo, Domenico Solari, and Felice Esposito, Naples, Italy

We are very thankful to the authors for the words of appreciation and the enthusiastic attitude they had towards our group and the manuscript to which this letter refers. Above all, we think that they should be praised for having drawn the attention on several important topics concerning craniopharyngiomas.

On one hand, we recognize that identification of the histopathology of such lesions is essential, as it correlates with age of incidence and, moreover, could help in detailing the topography of growth pattern. Indeed, many efforts have been spent in these regards, and it should be appreciated the cogent anatomical classification for craniopharyngiomas the authors defined [1] and reported herein; it is not surprising though to identify an overall rate of 40 % of lesions that can be classified as tuberoinfundibular tumor.

On the other, we agree about the relevance of depicting the anatomy of the infundibular–ventricular region and defining landmarks and tips and tricks to improve the understanding of such a disease and refine the surgical strategy. Along this virtuous circle, i.e., the anatomical knowledge, the neuroradiological preop study follows, as it requires precise knowledge and correct interpretation. Some anatomical structures, i.e., the floor of the third ventricle, the positioning of optic chiasm and pituitary stalk, and above all, their relationships with the pathology dealt with, should be recognized and, as well, disclosed in order to accomplish a striking disease management.

We found these issues to be extremely relevant, especially when approaching a craniopharyngioma involving the stalk–infundibular and/or ventricular regions from the endoscopic endonasal route. We embrace the position of the authors who underline the epicenter of the anatomical understanding in regards to the pathology.

References

1. Pascual JM, Prieto R, Carrasco R (2011) Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category. Acta Neurochir (Wien) 153(12):2403–2425; discussion 2426

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Pascual, J.M., Prieto, R., Dufourny, I.C. et al. Hypothalamus-referenced classification for craniopharyngiomas: evidence provided by the endoscopic endonasal approach. Neurosurg Rev 36, 337–340 (2013). https://doi.org/10.1007/s10143-012-0439-5

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  • DOI: https://doi.org/10.1007/s10143-012-0439-5

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