[Ectopic relapse of an operated craniopharyngioma. Case report and review of the literature].
INTRODUCTION. Craniopharyngioma is an embrionary tumor of the sellar and/suprasellar region derived from fusiform cells of Rathke´s cleft. Although locoregional relapse is the way classically proposed for relapse after treatment, it has been described, in a few cases, the possibility of ectopic relapse out of the sellar-suprasellar region, by direct seeding of cells during surgery on the surgical field, or by cell dissemination in the cerebrospinal fluid (CSF). It is proposed to report the case of a patient with relapse of a craniopharyngioma in the frontal lobe, who was previously operated ten years after, as well as to review the similar cases reported in the literature to the date. RESULTS. A systematic review of the literature has allowed to find 21 cases previously reported. Direct cellular seeding was the most frequent implantation mechanism. In all cases, the preferred treatment was radical surgical removal when this was possible. The time of latency between first surgery and relapse differed from 1 to 21 years. CONCLUSIONS. It is interesting, in the differential diagnosis, to bear in mind the possibility of ectopic relapse of craniopharyngioma in patients who have been operated because of this type of tumor and who present a new mass in nervous central system (CNS). In view of the long time of latency that can pass between the resection of a craniopharyngioma and his relapse, there becomes necessary a long follow-up of these patients by periodic imaging tests.
Servicios de Neurocirugía. Hospital Universitario Virgen de las Nieves, Granada.
M A
MA
Roldán-Serrano
M J
MJ
Katati
C
C
García-López
B
B
Iáñez-Velasco
C
C
Sánchez-Corral
A
A
Altuzarra-Corral
J L
JL
Lara-Cantalejo
D000368:Aged; D003397:Craniopharyngioma / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D003937:Diagnosis, Differential; D005625:Frontal Lobe / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D012008:Recurrence