A craniopharyngioma is a benign tumour arising from small nests of cells near the pituitary stalk.
- Embryological remnant from Rathke's pouch
- Found in sella turcica or suprasellar space
- Found in suprasellar cistern and 20% arises from sella
- Benign tumour sticks to local structures
- Can be cystic or solid and calcified
- Affects vision - bitemporal hemianopia but may not be perfectly symmetrical
- Hypothalamic: Hyperphagia and Obesity, delayed development, loss of thirst, temperature regulation issues
- Cranial Diabetes Insipidus
- U&E, LFTS, FBC, CRP. Osmolality
- Check pituitary function - Cortisol, GH etc..
- Consider short synacthen
- MRI: cystic lesions are hyperintense
- Eye perimetry
Management: tumours may recur after surgery
- Surgery to remove the tumour is usually the first step in treatment.
- Transphenoidal or craniotomy
- Shunting for hydrocephalus if present
- Radiation therapy may be suggested as an adjunct to surgery.
- Hormonal replacement where needed