Ectopic Craniopharyngioma in Adults

Introduction: Craniopharyngioma is an intracranial tumor usually located in the sellar-suprasellar region. They are histologically benign but locally aggressive and are associated with a high rate of recurrence and morbidity. Surgical resection is the primary treatment, but achieving gross total resection is challenging, which leads to both recurrence and progression of the disease. Ectopic seeding of craniopharyngioma is a rare but important complication. Seeding is thought to occur via the initial surgical tract or from dissemination through cerebrospinal fluid. Most recurrences occur in the first 5 years but delayed recurrences after initial treatment have been reported which makes long-term follow-up of these patients extremely important.

Objective: To perform a systematic review of the literature on ectopic craniopharyngioma in adults.

Method: A systematic review was performed using PubMed, Cochrane, and Google Scholar in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines including all studies with at least one case of Ectopic craniopharyngioma.

Results: A total of 48 articles have been included so far, for a total of 58 patients with confirmed ectopic craniopharyngioma. The most frequent variant reported was the adamantinomatous type. Calcification was significantly associated with no seeding. Cystic appearance on imaging was significantly associated with seeding. Finally seeding was more frequent after open approaches than endoscopic ones ([Table 1]).

Table 1

Conclusion: We found that some important factors when dealing with ectopic craniopharyngioma are the presence of calcifications as well as cystic appearance on imaging. Lavage after craniopharyngioma surgery especially when there is a cystic component is discussed. Seeding was significantly higher in patients who had open management compared to endoscopic management.

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Artikel online veröffentlicht:
05. Februar 2024