Craniopharyngioma
- Uncommon, benign (WHO I) tumor that occurs in both children & adults.
Subtypes of craniopharyngioma
Adamantinomatous craniopharyngioma
- epithelium that form stellate reticulum, wet keratin & basal palisades.
- Up to 95% of this variant shows CTNNB1 mutations & aberrant nuclear expression of β-catenin.
- Bimodal age distribution: childhood peak age 5–15 yrs, adult peak age 45–60 years.
Papillary craniopharyngioma
- epithelium that form papillary features.
- MC in supratentorial compartment or 3rd ventricle.
- 81–95% of cases show BRAF V600E mutations.
- Usually solid, or rarely cystic.
- almost exclusively in adults w/ ~40–55 y/o.
Overview of Adult and Pediatric Craniopharyngioma
| Adult | Pediatric | |
|---|---|---|
| EPIDEMIOLOGY | ||
| Age in years | 65–74 | 5–14 |
| Gender | M = F | M > F |
| Clinical presentation | Vision loss, hydrocephalus | Headaches, hydrocephalus |
| Endocrine dysfunction | Less common | Common |
| RADIOLOGY | ||
| Cysts | Less common | Common |
| Calcification | Less common | Common |
| PATHOLOGY TYPE | ||
| Adamantinomatous | Yes | Yes |
| Papillary | Yes | No |
| TREATMENT OPTIONS | ||
| Surgery | Yes | Yes |
| Radiotherapy | Yes | Yes |
| Targeted therapy | Yes (papillary subtype) | No |
| TREATMENT MORBIDITY | ||
| Surgery | Better tolerated than radiation | |
| Radiotherapy | Better tolerated than surgery |