title: Treatment of craniopharyngioma in adults: systematic analysis of a 25-year experience.
abstract: OBJECTIVE
  Craniopharyngioma is a rare and mostly benign epithelial tumor of the central nervous system, mostly affecting children. Considering that most of the published series of craniopharyngioma are based on pediatric populations, studies in adults gain importance based mainly on the reduced number of cases and the possible differences emerging from a mostly different histological type. We undertook this study to establish the pattern of presentation, morphological features and specific characteristics of craniopharyngioma in an adult Mexican population, as well as discussing the long-term outcome and how it may be influenced by surgical, anatomic and clinical factors.
  
  
  METHODS
  A total of 153 adult patients (16 years or older) underwent transcranial and transsphenoidal surgery between January 1985 and December 2009, all with histological confirmation of craniopharyngioma. Hypothalamic involvement, surgical complications, rate of tumor resection and endocrinological outcome were evaluated.
  
  
  RESULTS
  Seventy nine males (51.6%) and 74 females (48.4%) were included. Mean age at diagnosis was 32.4 years (range: 16-77 years). Mean initial tumor volume was 28.44 mL (range: 0.18-100.44 mL). Partial or complete hypothalamic involvement (Samii Grades III, IV and V) was found in 90.2%. The overall rate of new endocrinopathies was 37.25% after surgery (95% CI = 33.9-41.2).
  
  
  CONCLUSIONS
  Gross total removal of craniopharyngiomas with large hypothalamic involvement was related to poor neuroendocrine outcome in adults. Partial removal should be indicated, associated with adjuvant therapy, in order to improve postoperative neuroendocrine status.
authors: Division of Neurosurgery, "Instituto Nacional de Neurologia y Neurocirugia", Mexico City, Mexico. raullopezserna@hotmail.com
authors: Raul
authors: R
authors: Lopez-Serna
authors: Juan Luis
authors: JL
authors: Gómez-Amador
authors: Juan
authors: J
authors: Barges-Coll
authors: Edgar
authors: E
authors: Nathal-Vera
authors: Rogelio
authors: R
authors: Revuelta-Gutiérrez
authors: Mario
authors: M
authors: Alonso-Vanegas
authors: Miguel
authors: M
authors: Ramos-Peek
authors: Lesly
authors: L
authors: Portocarrero-Ortiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003397:Craniopharyngioma / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010911:Pituitary Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine