Craniopharyngiomas are benign tumors of the sellar and suprasellar region derived from the epithelial cells in Rathke´s pouch. Children and older adults have a higher incidence rate. The most common symptoms are: alteration of the field of vision, hormonal deficits and short stature in children. When these tumors generate hydrocephalus, they can cause headaches, vomiting and sensory alterations.
The presumptive diagnosis is made with an MRI and a Brain Tomography, where we can see the typical suprasellar, solid-cystic tumor with calcifications.
The best treatment for these tumors is total resection when possible. We have radiotherapy as an adjuvant for remnants of active tumors or for recurrent tumors.
Since the Craniopharyngiomas that originate in the hypothalamus pituitary axis are mainly midline and are in close relationship with the skull base, the endoscopic endonasal approach is the most frequently chosen path since it provides the most direct access to the region.
Our team prioritizes the endoscopic approach because it allows us to see the tumor more clearly and how it is positioned related to the hypothalamic pituitary axis in order to have the best chance of performing a total resection.
We present the case of a 20-year-old patient who experienced progressive loss of vision accompanied by drowsiness due to cortisol deficiency.
In this case, we were able to perform a total resection of the craniopharyngioma. The postoperative period was without complications. The correct total hormone replacement was performed and we did not need to use radiotherapy.
Note the high definition of the intraoperative images provided by the endoscopic endonasal route. This view allows us to make the most appropriate decision during the surgery in order to obtain the best result possible.