USMLE – Craniopharyngioma
Craniopharyngiomas are benign tumors which develop in cell rests of Rathke’s pouch and may be located within the sella turcica or commonly in the suprasellar space. They are often cystic and/or calcified. They occur more commonly in young people than do pituitary adenomas. They may present with pressure on adjacent structures, hypopituitarism or a hypothalamic syndrome. Craniopharyngiomas can rarely be reached by the trans-sphenoidal route and surgery involves a craniotomy, with a relatively high risk of hypothalamic damage and other complications. Surgery is unlikely to be curative and radiotherapy should probably be given, although there is uncertainty about its efficacy. Unfortunately, craniopharyngiomas often recur, requiring repeated surgery and inevitably causing considerable morbidity, usually from hypothalamic obesity and/or visual failure.