Craniopharyngiomas

What is Craniopharyngioma?

Craniopharyngioma is a rare, benign brain tumour that develops near the pituitary gland and hypothalamus. Though non-cancerous, its location in the brain can lead to significant health challenges as it may affect hormonal regulation, vision, and neurological functions. Craniopharyngiomas are most commonly diagnosed in children and older adults, with a bimodal age distribution.

Types of Craniopharyngiomas

Craniopharyngiomas are classified into two main subtypes based on their histological features:

1. Adamantinomatous Craniopharyngioma:

   • Common in children.

   • Contains calcifications visible on imaging.

   • Often cystic in nature, with thick fluid resembling motor oil.

2. Papillary Craniopharyngioma:

   • More frequently seen in adults.

   • Generally solid and lacks calcifications.

   • Associated with better surgical outcomes due to less invasive behaviour.

Symptoms of Craniopharyngioma

The symptoms of craniopharyngioma result from its pressure on nearby structures such as the optic nerves, pituitary gland, and hypothalamus. Common symptoms include:

• Visual Disturbances: Loss of peripheral vision or blurred vision.

• Endocrine Dysregulation: Hormonal imbalances leading to growth delays, weight changes, or diabetes insipidus.

• Headaches: Often due to increased intracranial pressure.

• Fatigue and Behavioural Changes: Resulting from hypothalamic involvement.

• Nausea and Vomiting: Associated with hydrocephalus caused by obstruction of cerebrospinal fluid pathways.

Diagnosis and Treatment Options

Diagnosis: Craniopharyngioma is diagnosed through a combination of imaging studies and clinical evaluations:

• MRI with Contrast: Provides detailed images of the tumour’s size, composition, and relationship to surrounding structures.

• CT Scan: Helps identify calcifications, particularly in adamantinomatous subtypes.

• Endocrine Evaluation: Assesses hormone levels to determine the extent of pituitary dysfunction.

Treatment: The management of craniopharyngioma aims to balance tumour control with preserving neurological and hormonal function:

1. Surgery:

   • The primary treatment to remove as much of the tumour as possible.

   • Minimally invasive approaches, such as endoscopic transsphenoidal surgery, are often preferred for reduced recovery time.

2. Radiotherapy:

   • Used post-surgery or as a primary treatment if the tumour is inoperable.

   • Stereotactic radiosurgery may precisely target residual tumour tissue while sparing healthy areas.

3. Hormone Replacement Therapy:

   • Necessary for managing pituitary deficiencies caused by the tumour or its treatment.

4. Supportive Care:

   • Includes rehabilitation therapies for vision, cognition, and emotional well-being.

Conclusion

Craniopharyngiomas, though benign, can have profound effects on health due to their location and potential to disrupt critical brain functions. Early diagnosis and a multidisciplinary approach to treatment are key to optimising outcomes. If you or your loved one is experiencing symptoms suggestive of a brain tumour, seek medical advice promptly. Visit the Singapore Brain Spine Nerves Center for expert care tailored to your needs and a comprehensive treatment plan designed for your journey to recovery.