Metastatic craniopharyngioma: case report and literature review.
BACKGROUND
Distant spread of craniopharyngioma is a rare but important complication. Most cases are a result of spread along the surgical path. We describe a rare case of metastatic leptomeningeal craniopharyngioma as a result of dissemination along CSF pathways in a child. A review of previously described cases is provided.


METHODS
A 14-year-old male was diagnosed with metastatic craniopharyngioma on routine follow-up imaging after multiple surgeries and radiation for locally recurrent craniopharyngioma. The lesion was erosive through the right parietal bone, but had remained clinically silent. The lesion was distant from previous surgical paths. The patient underwent right parietal craniotomy and resection of the lesion. Duraplasty and cranioplasty were necessary for closure. Histopathology confirmed adamantinomatous craniopharyngioma. One-year follow-up demonstrated no recurrence.


CONCLUSIONS
A review of reported cases suggests that leptomeningeal implantation may be an important step in metastases of craniopharyngioma, although the mechanism is poorly understood. Attention to tumor spillage at the time of surgery may be important in preventing distant recurrences.
Frangou
Evan Mark
EM
Division of Neurosurgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7K 0W8, Canada. uognarf@hotmail.com
Tynan
Jennifer Ruth
JR
Robinson
Christopher Adam
CA
Ogieglo
Lissa Marie
LM
Vitali
Aleksander Michal
AM
D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003397:Craniopharyngioma / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis