KUMJ | VOL. 16 | NO. 4 | ISSUE 64 | OCT.-DEC. 2018
Outcome of Surgical Resection of Craniopharyngioma: Single Center 12 Years’ Experience
Bishokarma S, Shrestha S, Ranabhat K, Koirala S, Shrestha D, Panth R, Gongal DN
Abstract: Background
Craniopharyngiomas (CPs) are rare epithelial tumors arising from the Rathke’s pouch
remnant located along the path of the craniopharyngeal duct accounting for 1.2-4%
of all primary intracranial brain tumors, the primary treatment of which is surgery.
Objective
Whether radical surgical resection or partial resection followed by radiotherapy is
a topic of debate. We presented our 12 years single center experience on surgical
resection of craniopharyngioma.
Method
This was a descriptive cross-sectional study conducted among forty-five patients who
underwent transcranial resection of craniopharyngioma during a period of 12 years.
Data were collected from medical record archives. Glassgow outcome score (GOS),
electrolyte imbalance and visual complications were assessed as outcome measure.
GOS > 3 was considered favorable while score ≤ 3 was considered unfavorable.
Recurrence of tumors were analyzed.
Result
Out of 45 patients, 28 patients were male with male to female ration of 1.64. Mean
age was 32.22±16.42 years. Supra-sellar craniopharyngioma were the most common
location. Gross total resection was accomplished in 32 patients (71.1%) while
subtotal resection among 13 patients (28.9%). Post-operative Diabetes Insipidus
was developed among 35 patients (77.7%). Adamantinomatous craniopharyngioma
was the most common histopathological type. Postoperative MRI with contrast
was repeated to ascertain the completeness of resection. All patient with subtotal
resection received radiotherapy. Follow up period ranged from 3 months to 8 years
with mean of 4.2 years. Favorable outcome (GOS>3) was seen among 41 patients
while unfavorable among 4 patients. Recurrence seen among 4 patients (8.9%).
Overall mortality was 4 (8.8%).
Conclusion
Gross total excision of craniopharyngioma has a favorable outcome with acceptable
morbidity.
Keyword : Adamantinomatous, Craniopharyngioma, Pterional craniotomy, Radiation therapy
