[Microsurgical treatment of adult craniopharyngiomas in 156 cases].
OBJECTIVE
To explore the clinical features, surgical approaches and outcomes of craniopharyngioma in adults.


METHODS
A total of 156 cases of adult craniopharyngioma underwent microsurgery at our hospital were retrospectively reviewed and classified into four types according to the location of tumor relative to sellar diaphragm and the third ventricle. They were divided into four groups: intrasellar type (n = 6), suprasellar & extraventricular type (n = 59), intraventricular type (n = 63) and mixed type (n = 28). Unilateral subfrontal approach was chosen in 9 cases, anterior interhemispheric approach in 14 cases, pterional approach in 102 cases, transcallosal approach in 28 cases and transsphenoidal approach in 3 cases.


RESULTS
Tumors were totally removed in 124 cases (79.5%), subtotally removed in 25 cases (16%) and partially removed in 7 cases (4.5%). Two patients died after surgery. Pituitary stalk was identified and protected intraoperatively in 69 cases, and postoperative diabetes insipidus occurred in 109 cases. The follow-up period ranged from 3 months to 5 years. 75.3% of the cases were capable of normal work and life and tumor recurred in 26 cases.


CONCLUSIONS
Selection of appropriate approach is the key to successful microsurgery for craniopharyngioma according to the site and growth pattern of tumor.
Jiang
Zhong-li
ZL
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. jangzhongli@sina.com
Ren
Xiao-hui
XH
Chu
Jun-sheng
JS
Lin
Song
S
Zhang
Mao-zhi
MZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D003397:Craniopharyngioma / Q000145:classification / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult