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Surgery for pediatric craniopharyngiomas: is less more?

  • Jörg Flitsch EMAIL logo , Jens Aberle and Till Burkhardt
Published/Copyright: December 13, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 28 Issue 1-2

Abstract

Surgery for craniopharyngiomas, especially in childhood and adolescence, has evolved from an era of aggressive strategies – with the primary goal of gross total removal and accepting an impaired functional outcome – to a more individually tailored therapy that avoids immediate treatment-related and long-term morbidity. Modern imaging techniques and a wider understanding of hypothalamic risk factors have led to surgical strategies adapted to the localization of these inhomogenously grown pathologies. Whereas purely infradiaphragmatic as well as supradiaphragmatic/infrachiasmatic tumors have a favorably surgical outcome with higher gross total resection rates in experienced hands, lesions within the third ventricle extending beyond the mammillary bodies remain a problem. The same is valid for lesions beyond 3 cm in diameter, more or less independent of their localization. Aside from the traditional microscopic approach via the subfrontal or pterional craniotomy, transsphenoidal approaches and other minimal invasive surgical methods, e.g., catheter implantation into cystic formations of the tumor have become popular. Radiotherapy, with its risks and limitations, can effectively be added to avoid recurrences. Nowadays, surgery as part of an interdisciplinary treatment strategy is still the typical first choice. However, taking the patient’s long-term prognosis into considertaion, the surgical complication rates have to be minimized.

Keywords: craniopharyngioma; quality of life; surgery
Corresponding author: Jörg Flitsch, MD, Interdisciplinary Endocrinology/Pituitary Surgery, Dept. of Neurosurgery, University Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany, Phone: 0049-40-7410-53757, Fax: 0049-40-7410-40044, E-mail:

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Received: 2014-10-7
Accepted: 2014-11-12
Published Online: 2014-12-13
Published in Print: 2015-1-1

©2015 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Childhood Craniopharyngioma
  3. Selected papers from the 3rd International Multidisciplinary Postgraduate Course, April 24–27, 2014
  4. Childhood craniopharyngioma – current status and recent perspectives in diagnostics and treatment
  5. The importance of interdisciplinary communication with patients about complex, chronic illnesses: our experiences as parents of a child with a craniopharyngioma
  6. Adamantinomatous craniopharyngioma: pathology, molecular genetics and mouse models
  7. Endocrine aspects and sequel in patients with craniopharyngioma
  8. Surgery for pediatric craniopharyngiomas: is less more?
  9. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma
  10. Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children: single institution experience
  11. Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity
  12. Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment
  13. Review article
  14. Association study of TAC3 and TACR3 gene polymorphisms with idiopathic precocious puberty in Chinese girls
  15. Images in pediatric endocrinology
  16. Intestinal invagination in diabetic ketoacidosis: case report
  17. Original articles
  18. Managing incidental findings and disclosure of results in a paediatric research cohort – the LIFE Child Study cohort
  19. The heterogeneity of hyperinsulinaemic hypoglycaemia in 19 patients with Beckwith-Wiedemann syndrome due to KvDMR1 hypomethylation
  20. Gender differences and age-related changes in body fat mass in Tibetan children and teenagers: an analysis by the bioelectrical impedance method
  21. A study of genes involved in adipocyte differentiation
  22. Initiation of growth hormone therapy in idiopathic short stature: do gender differences exist?
  23. The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance
  24. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees
  25. Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions
  26. Variability of lipid and lipoprotein concentrations during puberty in Brazilian boys
  27. Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth
  28. Can optical coherence tomography predict early retinal microvascular pathology in type 1 diabetic adolescents without minimal diabetic retinopathy? A single-centre study
  29. Decreased levels of homoarginine and asymmetric dimethylarginine in children with type 1 diabetes: associations with cardiovascular risk factors but no effect by atorvastin
  30. Influence of catch-up growth on abdominal fat distribution in very low birth weight children – cohort study
  31. Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents
  32. Pulmonary function in children with type 1 diabetes mellitus
  33. Identification of deletions in children with congenital hypothyroidism and thyroid dysgenesis with the use of multiplex ligation-dependent probe amplification
  34. Effect of l-thyroxine supplementation on infants with transient hypothyroxinemia of prematurity at 18 months of corrected age: randomized clinical trial
  35. Vitamin D-containing supplements for children between 1–3 years of age: Are they essential for bone health?
  36. Anti-Mullerian hormone levels in American girls by age and race/ethnicity
  37. The effect of tailoring of cornstarch intake on stature in children with glycogen storage disease type III
  38. Thyroid disease in Chinese girls with Turner syndrome
  39. Patient reports
  40. Pure gonadal dysgenesis (Swyer syndrome) due to microdeletion in the SRY gene: a case report
  41. Hypophosphatemic rickets caused by a novel splice donor site mutation and activation of two cryptic splice donor sites in the PHEX gene
  42. Novel heterozygous IGF1R mutation in two brothers with developing impaired glucose tolerance
  43. A case of pediatric ectopic thyroid in lateral lymph nodes
  44. Hyperostosis-hyperphosphatemia syndrome (HHS): report of two cases with a recurrent mutation and review of the literature
  45. Needle detachment from the Sure-T® infusion set in two young children with diabetes mellitus (DM) treated with continuous subcutaneous insulin infusion (CSII) and unexplained hyperglycaemia
  46. Familial dysalbuminemic hyperthyroxinemia in a 4-year-old girl with hyperactivity, palpitations and advanced dental age: how gold standard assays may be misleading
https://doi.org/10.1515/jpem-2014-0417
Keywords for this article
craniopharyngioma; quality of life; surgery

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Childhood Craniopharyngioma
  3. Selected papers from the 3rd International Multidisciplinary Postgraduate Course, April 24–27, 2014
  4. Childhood craniopharyngioma – current status and recent perspectives in diagnostics and treatment
  5. The importance of interdisciplinary communication with patients about complex, chronic illnesses: our experiences as parents of a child with a craniopharyngioma
  6. Adamantinomatous craniopharyngioma: pathology, molecular genetics and mouse models
  7. Endocrine aspects and sequel in patients with craniopharyngioma
  8. Surgery for pediatric craniopharyngiomas: is less more?
  9. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma
  10. Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children: single institution experience
  11. Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity
  12. Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment
  13. Review article
  14. Association study of TAC3 and TACR3 gene polymorphisms with idiopathic precocious puberty in Chinese girls
  15. Images in pediatric endocrinology
  16. Intestinal invagination in diabetic ketoacidosis: case report
  17. Original articles
  18. Managing incidental findings and disclosure of results in a paediatric research cohort – the LIFE Child Study cohort
  19. The heterogeneity of hyperinsulinaemic hypoglycaemia in 19 patients with Beckwith-Wiedemann syndrome due to KvDMR1 hypomethylation
  20. Gender differences and age-related changes in body fat mass in Tibetan children and teenagers: an analysis by the bioelectrical impedance method
  21. A study of genes involved in adipocyte differentiation
  22. Initiation of growth hormone therapy in idiopathic short stature: do gender differences exist?
  23. The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance
  24. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees
  25. Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions
  26. Variability of lipid and lipoprotein concentrations during puberty in Brazilian boys
  27. Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth
  28. Can optical coherence tomography predict early retinal microvascular pathology in type 1 diabetic adolescents without minimal diabetic retinopathy? A single-centre study
  29. Decreased levels of homoarginine and asymmetric dimethylarginine in children with type 1 diabetes: associations with cardiovascular risk factors but no effect by atorvastin
  30. Influence of catch-up growth on abdominal fat distribution in very low birth weight children – cohort study
  31. Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents
  32. Pulmonary function in children with type 1 diabetes mellitus
  33. Identification of deletions in children with congenital hypothyroidism and thyroid dysgenesis with the use of multiplex ligation-dependent probe amplification
  34. Effect of l-thyroxine supplementation on infants with transient hypothyroxinemia of prematurity at 18 months of corrected age: randomized clinical trial
  35. Vitamin D-containing supplements for children between 1–3 years of age: Are they essential for bone health?
  36. Anti-Mullerian hormone levels in American girls by age and race/ethnicity
  37. The effect of tailoring of cornstarch intake on stature in children with glycogen storage disease type III
  38. Thyroid disease in Chinese girls with Turner syndrome
  39. Patient reports
  40. Pure gonadal dysgenesis (Swyer syndrome) due to microdeletion in the SRY gene: a case report
  41. Hypophosphatemic rickets caused by a novel splice donor site mutation and activation of two cryptic splice donor sites in the PHEX gene
  42. Novel heterozygous IGF1R mutation in two brothers with developing impaired glucose tolerance
  43. A case of pediatric ectopic thyroid in lateral lymph nodes
  44. Hyperostosis-hyperphosphatemia syndrome (HHS): report of two cases with a recurrent mutation and review of the literature
  45. Needle detachment from the Sure-T® infusion set in two young children with diabetes mellitus (DM) treated with continuous subcutaneous insulin infusion (CSII) and unexplained hyperglycaemia
  46. Familial dysalbuminemic hyperthyroxinemia in a 4-year-old girl with hyperactivity, palpitations and advanced dental age: how gold standard assays may be misleading
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