Significance of radiological identification of the pituitary stalk in surgical removal of craniopharyngiomas.
OBJECTIVE
To explore the radiological characteristics of craniopharyngiomas and particularly, to discuss the radiological manifestations of the pituitary stalk and their significance in safe resection of craniopharyngiomas.


METHODS
Retrospective analyses of the data obtained in preoperative radiological evaluation and intraoperative observation were conducted in 63 cases of craniopharyngiomas that were surgically removed.


RESULTS
In 6 cases (9.5%) the pituitary stalk was identified in preoperative radiological examination, and in 17 cases (27%) the position and course of pituitary stalk could be presumed according to the displacement of the third ventricle floor, which were confirmed in all cases during the operation. While in the other 33 (52.5%) cases, the pituitary stalk was only located during the operation. Massive calcification in the central position of the tumor stood in the way of achieving complete tumor removal, and the irregular peripheral enhancement in the superoposterior part of the tumor indicated tumor invasion of the hypothalamus.


CONCLUSIONS
Preoperative identification of the pituitary stalk and tumor calcification, together with a clear understanding of the position of the posterior part of the tumor in association with the hypothalamus is crucial to safe and complete surgical removal of craniopharyngiomas.
Qi
Song-Tao
ST
Department of Neurosurgery, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Pan
Jun
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000000981:diagnostic imaging* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies