title: [The 2013 Sixto Obrador Award. A triple-axis topographical model for surgical planning of craniopharyngiomas. Part I: historical review of the topographical diagnosis and classification schemes of craniopharyngiomas].
abstract: OBJECTIVE
  This study reviews the historical evolution of pathological, neuroradiological and surgical evidence that influenced the topographical concepts and classification schemes of craniopharyngiomas.
  
  
  METHODS
  An extensive, systematic analysis of the surgical series of craniopharyngiomas reported in the literature was performed (n=145 series, 4,588 tumours) to describe the fundamental anatomical findings guiding the topographical classification schemes used for this tumour throughout history. These findings were compared with topographical relationships reported for well-described operated craniopharyngiomas (n=224 cases) as well as for non-operated cases studied in autopsies (n=201 cases).
  
  
  RESULTS
  Two major variables define the topography of a craniopharyngioma: its position relative to the sellar diaphragm and its degree of invasion of the third ventricle floor. Suprasellar lesions displacing the third ventricle floor upwards (pseudointraventricular craniopharyngiomas) are amenable to safe, radical resection and must be differentiated from lesions developing primarily within the third ventricle floor (infundibulo-tuberal or not strictly intraventricular craniopharyngiomas). The latter group typically shows tight, circumferential adhesion to the third ventricle floor and represents approximately 40% of all cases.
  
  
  CONCLUSIONS
  A triple-axis topographical model for craniopharyngiomas that includes the degree of hypothalamus invasion is useful in planning surgical approach and degree of resection. The group of infundibulo-tuberal craniopharyngiomas associates the highest risk of hypothalamic injury (50%). The endoscopically-assisted extended transsphenoidal approach provides a proper view to assess the topography of the craniopharyngioma and its degree of adherence to the hypothalamus.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de La Princesa, Madrid, España. Electronic address: jmpasncj@hotmail.com.
authors.forename: José María
authors.initials: JM
authors.lastname: Pascual
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Ruth
authors.initials: R
authors.lastname: Prieto
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Carrasco
authors.affiliation: Sección de Endocrinología, Hospital Universitario del Sureste, Arganda del Rey, Madrid, España.
authors.forename: Inés
authors.initials: I
authors.lastname: Castro-Dufourny
authors.affiliation: Facultad de Medicina, Technische Universität, Dresden, Germany.
authors.forename: Sewan
authors.initials: S
authors.lastname: Strauss
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de La Princesa, Madrid, España.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gil-Simoes
authors.affiliation: Centro Técnico de Informática, CSIC, Madrid, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Barrios
mesh_terms: D001363:Awards and Prizes; D003397:Craniopharyngioma / Q000145:classification* / Q000175:diagnosis* / Q000266:history / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008953:Models, Anatomic; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000145:classification* / Q000175:diagnosis* / Q000266:history / Q000601:surgery; D020542:Third Ventricle / Q000473:pathology
keywords: Craneofaringioma; Craniopharyngioma; Hipotálamo; Hipófisis; Hypophysis; Hypothalamus; Mammillary body angle; Tercer ventrículo; Third ventricle; Tuber cinereum; Ángulo mamilar