Papillary craniopharyngioma: A clinicopathological study of 48 cases

T. B. Crotty, B. W. Scheithauer, W. F. Young, D. H. Davis, E. G. Shaw, G. M. Miller, P. C. Burger

Research output: Contribution to journalArticle

Abstract

Two distinct clinicopathological variants of craniopharyngioma exist: the classic adamantinomatous type and a recently described papillary form that predominates in adults and reportedly behaves in a less aggressive manner. The present study describes the clinicopathological features of 48 patients with papillary craniopharyngioma treated at the Mayo Clinic between 1910 and 1994. An additional four tumors were found to have histological features of both adamantinomatous and papillary craniopharyngioma. Whereas adamantinomatous tumors typically occur in adolescent patients, the mean age of the 48 patients (23 males and 25 females) with papillary craniopharyngioma was 44.7 years (range 10 to 74 years). Presenting clinical features included visual impairment (84%), headache (68%), and pituitary insufficiency (anterior 42%; posterior 27%). Preoperative computerized tomography (CT) and magnetic resonance (MR) imaging in 17 patients typically revealed a noncalcified, partially cystic mass that enhanced peripherally and contained mural nodules (67%). Many (41%) of the lesions involved or extended into the third ventricle on imaging. At first surgery, gross total tumor removal was achieved in 17 patients (36%) and subtotal resection in 30 patients (64%) in whom tumor resection was attempted. Tumor recurrence was noted in two patients who underwent gross total removal. Tumor free survival rates of 100% and 78% were obtained in patients who underwent gross total and subtotal resection at initial surgery, respectively. Postoperative radiation therapy was beneficial to patients having undergone a subtotal resection, with an increase in tumor-free survival from 26% to 86%. Aside from well-documented morphological distinctions, papillary craniopharyngiomas differ from adamantinomatous tumors in several important respects. These include the almost exclusive occurrence of papillary tumors in adulthood and their more uniform appearance on both CT and MR imaging. However, a preliminary analysis of our data suggests there are no significant differences between the two lesions with respect to resectability, efficacy of radiation therapy, and overall survival.

Original languageEnglish (US)
Pages (from-to)206-214
Number of pages9
JournalJournal of Neurosurgery
Volume83
Issue number2
StatePublished - 1995
Externally publishedYes

Fingerprint

Craniopharyngioma
Neoplasms
Radiotherapy
Tomography
Magnetic Resonance Imaging
Hypopituitarism
Third Ventricle
Survival
Vision Disorders
Headache
Survival Rate
Recurrence

Keywords

  • craniopharyngioma
  • endocrinology
  • morphological study
  • prognosis
  • third ventricle

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Crotty, T. B., Scheithauer, B. W., Young, W. F., Davis, D. H., Shaw, E. G., Miller, G. M., & Burger, P. C. (1995). Papillary craniopharyngioma: A clinicopathological study of 48 cases. Journal of Neurosurgery, 83(2), 206-214.

Papillary craniopharyngioma : A clinicopathological study of 48 cases. / Crotty, T. B.; Scheithauer, B. W.; Young, W. F.; Davis, D. H.; Shaw, E. G.; Miller, G. M.; Burger, P. C.

In: Journal of Neurosurgery, Vol. 83, No. 2, 1995, p. 206-214.

Research output: Contribution to journalArticle

Crotty, TB, Scheithauer, BW, Young, WF, Davis, DH, Shaw, EG, Miller, GM & Burger, PC 1995, 'Papillary craniopharyngioma: A clinicopathological study of 48 cases', Journal of Neurosurgery, vol. 83, no. 2, pp. 206-214.
Crotty TB, Scheithauer BW, Young WF, Davis DH, Shaw EG, Miller GM et al. Papillary craniopharyngioma: A clinicopathological study of 48 cases. Journal of Neurosurgery. 1995;83(2):206-214.
Crotty, T. B. ; Scheithauer, B. W. ; Young, W. F. ; Davis, D. H. ; Shaw, E. G. ; Miller, G. M. ; Burger, P. C. / Papillary craniopharyngioma : A clinicopathological study of 48 cases. In: Journal of Neurosurgery. 1995 ; Vol. 83, No. 2. pp. 206-214.
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