January - March 2020, Volume 16, Issue 1

Ciurea AV, Saceleanu V, Mohan A, Moreanu MS, Toader C

Craniopharyngiomas in Children - Experience of Consecutive 152 Operated Cases

Acta Endo (Buc) 2020, 16 (1): 103-109
doi: 10.4183/aeb.2020.103

Context. Craniopharyngiomas (CPH) are benign tumors, rarely encountered in children, representing 5-6% of all intracranial tumors. Objective. This study aimed to analyze the surgical management and quality of life in a series of CPH pediatric cases. Design. This was a multicenter study performed over a 25-year period (1994 - 2019) in Bucharest. Subjects and Methods. 152 children (0-17 years old) were treated for CPH. Preoperative manifestations were intracranial hypertension, endocrine dysfunction, visual impairment, ataxia, intellectual performance decrease. Results. Considering all surgical approaches used, we advocate for pterional approach to best fit in CPH. We achieved gross-total removal (GTR) in 83 cases (54.4%), near-total resection (NTR) in 13 cases (9%), partial resection (PTR) in 51 cases (33.3%). 5 cases were biopsies (3.2%). Gamma Knife Surgery was performed in 10 cases (6.5%), all recurrences. At 6 months GOS revealed: Good Recovery 70 cases (46.2%), Moderate Disability 62 cases (40.7%), Severe Disability 13 (8.5%), Vegetative State 2 cases (1.3%), Deceased 5 cases (3.2%). Complications were: diabetes insipidus (89.3%); hypopituitarism (66.4%); hypothalamic damage (17.7%); visual deterioration (18.4%). Conclusions. Surgery remains the main option, but GTR complications prove the necessity for a multidisciplinary approach. Outcome predicting factors are: age, tumor size, hydrocephalus degree, hypothalamic dysfunction.

Keywords: Craniopharyngiomas, MRI, Children, CPH Scale, Gamma Knife Surgery, Glasgow Outcome Scale, Quality of life.

Correspondence: Mihai-Stelian Moreanu, “Carol Davila” University of Medicine and Pharmacy, Andronache 209, Bucharest, 022524, Romania, E-mail: moreanumihai@yahoo.com