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Craniopharyngioma: Current Classification, Management, And Future Directions

Z. Habibi, Deya Abu Reesh, J. Rutka
Published 2019 · Medicine

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Craniopharyngioma is one of the most challenging brain tumors, located in sellar/suprasellar region in close proximity to the optic apparatus and hypothalamus. Although histologically low grade, the tumor can be locally aggressive and serve as a source of considerable morbidity due to compression and/or adherence to nearby structures. Due to its unpredictable natural history and long-term sequelae of various treatments, the ideal management of craniopharyngioma has been constantly debated over several generations of neurosurgeons. Many clinical series have advocated for gross total resection (GTR) to reduce the risk of tumor recurrence, while craniopharyngiomas are considered unresectable lesions by other authors and a recommendation for a more conservative neurosurgical approach followed by radiation therapy or intracystic treatment is given. The ongoing debate regarding the use of “aggressive” or “less invasive” surgical approaches has at least the benefit of suggesting that treatment plans should be customized to the individual patient and tumor characteristics. In this way, the maximum, safe neurosurgical procedure can be performed while minimizing untoward patient morbidity.
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