title: Malignant Transformation of Radiotherapy-Naïve Craniopharyngioma.
abstract: BACKGROUND
  Craniopharyngioma is a rare benign intracranial neoplasm that is successfully managed with surgery or adjuvant radiotherapy. The malignant transformation of craniopharyngioma has seldom been reported.
  
  
  METHODS
  A 30-year-old woman presented with a 5-month history of amenorrhea and was admitted to the hospital. She underwent surgical resection for three times and died at last. MRI revealed a new solid component of craniopharyngioma. Pathologic examination revealed malignant changes in the craniopharyngioma. In addition, We analyzed the expression of Ki-67, p53, VEGF, and MMP-9 in this malignant case after the third operation and in samples from 9 benign craniopharyngiomas. Immunohistochemical analysis showed that the Ki-67 index was higher in malignant craniopharyngiomas (50%) compared with benign craniopharyngiomas (3.0% ± 1.5%; range, 1.0%-6.0%). The p53, MMP-9, and VEGF protein levels were higher in the malignant craniopharyngioma compared with the benign craniopharyngiomas.
  
  
  CONCLUSIONS
  Patients with a high Ki-67 index and high p53, MMP-9, and VEGF protein levels and a new solid component of craniopharyngioma on MRI may benefit from aggressive treatment and close surveillance.
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Chunhui
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chuzhong
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhenye
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Sun
authors.initials: S
authors.lastname: Yilin
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: zyz2004520@yeah.net.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yazhuo
mesh_terms: D000328:Adult; D016371:Cranial Irradiation; D003397:Craniopharyngioma / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000601:surgery*; D018365:Neoplasm, Residual; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome
keywords: Craniopharyngioma; Electron microscope; Immunohistochemistry; Malignant transformation; Radiotherapy