Endoscopic Endonasal Transsphenoidal, Transclival Resection of a Recurrent Sellar and Ectopic Cerebellopontine Angle Craniopharyngioma

Craniopharyngioma is a benign but challenging tumor that commonly occurs in the sellar region. Ectopic recurrence is rare with only 63 cases reported in the literature mostly of the adamantinomatous type with the CPA being the second most common location. The proposed mechanism of ectopic recurrence is through CSF seeding. We present a case of a 14-year-old male with a history of sellar craniopharyngioma who underwent two previous pterional craniotomy and subtotal resection, followed by radiotherapy 6 years ago. Since the surgery, he has been on a hormonal replacement for panhypopituitarism and had decreased right visual acuity. He presented with a worsening headache, decreased visual acuity, right sided weakness, and slurred speech. Imaging showed a recurrence of the sellar craniopharyngioma with a new separate CPA component. He underwent endoscopic, endonasal, transsphenoidal, transclival near total resection of both lesions in the same procedure with reconstruction by fascia lata graft and nasoseptal flap. Postoperatively he made a full recovery and discharged home in stable condition ([Figs. 1]–[4]).

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Artikel online veröffentlicht:
05. Februar 2024