Prospective observational study of outcomes of different transcranial approaches for craniopharyngiomas
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Date
2019-12
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SCTIMST
Abstract
Craniopharyngioma:
“One would expect these congenital epithelial tumors to be capable of
enucleation like Dermoid cysts elsewhere in the body, but they so definitely adhere to
the adjacent structures neighboring on their place of origin, it is rarely possible to
shell them out of their bed without the production of serious secondary symptoms. To
be sure, one may occasionally succeed in stripping out a thin-walled cyst, and
examples of this have been reported, but when the tumor is partly solidified, and
calcareous, sad experience warns the surgeon to leave it pretty much alone.” Harvey
Cushing, 1932. (1)
“Though this tumor is still an ominous disease, it seems fair to say, that the
outlook has improved considerably.” (2)
Craniopharyngiomas are rare CNS tumors defined by WHO as benign, partly
cystic epithelial tumor of the sellar region presumably derived from Rathke’s pouch
epithelium. While it is benign in nature, the adhesion to surrounding structures may
result in damage to sellar and parasellar tissues during surgery and hence it is called
“Benign Tumor in a malignant location.” (3)
However due to introduction of hormonal therapy has allowed optimal
correction endocrinal deficiency, and improvement in radiation and microsurgical
techniques have improved survival enormously, it is the quality of survival that has
become real challenges.
The results of the published studies of neuropsychological outcome in children
are often conflicting and controversial. However surgical approaches of
craniopharyngioma need to be addressed with regards to neuropsychological outcome.
This study serves the above mentioned purpose.