Treatment of Craniopharyngioma in Adults: Systematic Analysis of a 25-year Experience
| Autor: | Juan Barges-Coll, Edgar Nathal-Vera, Juan Luis Gómez-Amador, Rogelio Revuelta-Gutiérrez, Mario Alonso-Vanegas, Raul Lopez-Serna, Miguel Ramos-Peek, Lesly Portocarrero-Ortiz |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Hypothalamo-Hypophyseal System medicine.medical_specialty Adolescent medicine.medical_treatment Pituitary-Adrenal System Thyrotropin Kaplan-Meier Estimate Hypopituitarism Pituitary neoplasm Statistics Nonparametric Craniopharyngioma Young Adult medicine Adjuvant therapy Humans Pituitary Neoplasms Benign epithelial tumor Aged Retrospective Studies Transsphenoidal surgery business.industry General Medicine Middle Aged medicine.disease Tumor Burden Surgery Thyroxine Multivariate Analysis Total removal Triiodothyronine Female Seventy Nine business |
| Zdroj: | Archives of Medical Research. 43:347-355 |
| ISSN: | 0188-4409 |
| Popis: | Background and Aims Craniopharyngioma is a rare and mostly benign epithelial tumor of the central nervous system, mostly affecting children. Considering that most of the published series of craniopharyngioma are based on pediatric populations, studies in adults gain importance based mainly on the reduced number of cases and the possible differences emerging from a mostly different histological type. We undertook this study to establish the pattern of presentation, morphological features and specific characteristics of craniopharyngioma in an adult Mexican population, as well as discussing the long-term outcome and how it may be influenced by surgical, anatomic and clinical factors. Methods A total of 153 adult patients (16 years or older) underwent transcranial and transsphenoidal surgery between January 1985 and December 2009, all with histological confirmation of craniopharyngioma. Hypothalamic involvement, surgical complications, rate of tumor resection and endocrinological outcome were evaluated. Results Seventy nine males (51.6%) and 74 females (48.4%) were included. Mean age at diagnosis was 32.4 years (range: 16–77 years). Mean initial tumor volume was 28.44 mL (range: 0.18–100.44 mL). Partial or complete hypothalamic involvement (Samii Grades III, IV and V) was found in 90.2%. The overall rate of new endocrinopathies was 37.25% after surgery (95% CI = 33.9–41.2). Conclusions Gross total removal of craniopharyngiomas with large hypothalamic involvement was related to poor neuroendocrine outcome in adults. Partial removal should be indicated, associated with adjuvant therapy, in order to improve postoperative neuroendocrine status. |
| Databáze: | OpenAIRE |
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