Adult Craniopharyngiomas: Long-Term Outcome after Surgical Resection

• Published in: Journal of Neurological Surgery Part B: Skull Base Vol. 75; no. S 02
• Main Authors: Leimert, Mario, Juratli, T. A., Neidel, J., Hümpfer, T., Soucek, S., Gerber, J., Schackert, G., Pinzer, T.
• Format: Conference Proceeding Journal Article
• Language: English
• Published: 17.06.2014
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0034-1384115

Objective : To analyze the long-term data of adults who underwent a surgical resection of a craniopharyngioma (CP). Methods : Data of adults with CP who underwent surgery between 1992 and 2011 were retrospectively collected and enrolled in a data bank. The collected data comprises: patients' history, imaging data, operative and clinical records, as well as hormonal and visual recovery. Results : We identified 48 CP adult patients, with a median age of 42 years. Most patients were preoperatively presented with visual disturbances or/and headache (68%). An affected gonadal function was the most common endocrinological failure, seen in 16 patients. Surgically, the pterional approach was most frequently performed (58.4%), followed by the transnasal-transsphenoidal approach (18.7%). A MRI confirmed complete resection was achieved in 31 patients (77.5%). Overall 12 patients underwent a second surgery due to a local recurrence with a median recurrence time of 17 months (4.6-146 months). A second recurrence was seen in four patients with a median time of 23.5 months. Postoperative complications contained: diabetes insipidus (five patients), deterioration of the visual acuity (three patients), postoperative hemorrhages in three patients and cognitive deficits in seven patients. The 5-year survival in our series is 93%. However, three patients died within the first 5 months after surgery due to severe hypothalamo-hypophyseal disturbances. Conclusion : The risk of postoperative deficits in adults CP is high.