Craniopharyngioma: a review of long-term visual outcome.
OBJECTIVE
To assess the clinical presentation and long-term visual outcome in a series of patients with craniopharyn-gioma.


METHODS
Retrospective case review.


RESULTS
Thirty-six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2-77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow-up period for all cases was 10 years.


CONCLUSIONS
Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one-third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro-ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour.
Chen
Celia
C
Neuro-Ophthalmology Service, Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia. celiachen@bigpond.com
Okera
Salim
S
Davies
Peter E
PE
Selva
Dinesh
D
Crompton
John L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006423:Hemianopsia / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014786:Vision Disorders / Q000150:complications / Q000473:pathology; D014785:Vision, Ocular; D014792:Visual Acuity; D014794:Visual Fields