craniopgaryngioma

Question 1

define craniopharyngioma

Answer 1

Slow growing, benign tumour of CNS, which causes symptoms through compression of surrounding structures

Question 2

what are the two histological subtypes of craniopharyngioma?**

Answer 2

Adamantinomatous craniopharyngioma (ACP)

Papillary CP (PCP)

Question 3

describe ACP ( Adamantinomatous craniopharyngioma )

Answer 3

ACP is more common and is derived from the remnant ectodermal cells of Rathke’s pouch

Question 4

Where are craniopharyngiomas commonly located?

Answer 4

in the suprasellar region of the brain.

Question 5

what do craniopharyngiomas do to surrounding structures?

Answer 5

Can compress surrounding structures such as the pituitary gland (leading to hypopituitarism) and the optic chiasm/nerves.

Question 6

describe the nature of craniopharyngiomas ( rate of growth and how they spread)

Answer 6

Craniopharyngiomas are slow-growing and locally invasive (spreads to nearby tissue)

Question 7

what are the signs of craniopharyngiomas?

Answer 7

-Hypopituitarism (e.g. GH, ACTH, TSH)
-Hydrocephalus
-Visual Disturbances

Question 8

what are the symptoms of craniopharyngiomas?

Answer 8

-Headaches
-Nausea
-Vomiting

Question 9

what is the epidemiology for craniopharyngiomas?

Answer 9

-Incidence of 0.5 to 2 cases per million a year
-Can be diagnosed in both children (5 – 14) and adults (50 to 74)
-Very high recurrence rate of 50%

Question 10

what are the three types of treatment/ management for craniopharyngiomas?

Answer 10

• pre- operative
• surgery
• radiotherapy

Question 11

describe the pre-operative treatment for craniopharyngiomas

Answer 11

-Hormonal deficiencies (e.g. Secondary Adrenal insufficiency, hypothyroidism) treated with hormone replacement before surgery

Question 12

describe the surgery treatment for craniopharyngiomas

Answer 12

Endoscopic Endonasal Transsphenoidal (EET) surgical removal of tumour

Question 13

what is radiotherapy treatment used for in craniopharyngiomas?

Answer 13

Used for residual disease or to prevent recurrences

Question 14

how are craniopharyngiomas diagnosed?

Answer 14

• CT or MRIs- used to diagnose with evaluation of visual symptoms
• Visual Examination- for patients with visual disturbances
• Endocrine evaluation

Question 15

what does an endocrine evaluation check for in craniopharyngioma?

Answer 15

evaluation completed to check for hormonal deficiencies, to check for:
-Fasting Morning cortisol + ACTH
-TSH + Free T4
-FSH + Oestradiol + Testosterone
-GH + IGH-1
-Prolactin