Evaluation of Various Modalities of Craniopharyngiomas Management: A Preliminary Study of Twenty Cases

Background: Craniopharyngioma is a histological benign epithelial tumor arising from the remnants of the Rathke’s pouch. Owing to their aggressive infiltrative behavior, the optimal treatment of craniopharyngioma remains a challenge. Objective: The aim of this work is to evaluate indications, efficacy and safety of various modalities used for treatment of craniopharyngiomas. Patients and Methods: This study was conducted on twenty consecutive patients between October 2012 and October 2014 presenting with craniopharyngiomas. The follow-up period ranged from 2 - 24 months. Results: This study included twelve females and eight males, the age ranged from 5-50 years with mean age of 25.45 years. Visual impairment was the most common presenting complaint. Treatment modalities used in this work included; surgical excision, Gamma knife radiosurgery, external beam radiation therapy, and Ommaya reservoir. Visual function improved in three cases without deterioration or improvement in other cases. No change in the pretreatment endocrinological status apart from three surgically treated cases required long-term ADH treatment. Three cases died in the early postoperative period. Conclusion: Analysis of clinical and imaging parameters designated that patients with a worse prognosis are those presented with hypothalamic dysfunction, hydrocephalus, large tumors, peritumoral edema, and calcifications.