Craniopharyngiomas​

Craniopharyngioma Symptoms and Diagnosis

Diagnosing craniopharyngioma

To make the diagnosis of craniopharyngioma, your doctor may:

• Ask you about your symptoms and medical history.
• Perform a physical exam.
• Order diagnostic tests, such as MRI and CT scans.

Symptoms of craniopharyngiomas

Craniopharyngioma symptoms include:

• Headache due to increasing pressure on the brain
• Nausea and vomiting
• Balance problems
• Vision problems due to the tumor pressing on or damaging the optic nerve
• Disruption of hormone production by the pituitary gland

Craniopharyngioma complications

Other conditions may result from damage to the pituitary gland done by the craniopharyngioma, including:

• Hypothyroidism (weight gain, fatigue, cold intolerance, and constipation)
• Adrenal failure (dizziness, hypoglycemia, cardiac arrhythmias, lethargy, confusion, anorexia, nausea, and vomiting)
• Diabetes insipidus (excessive thirst and urination)
• Decreased sexual drive, including impotence in men and amenorrhea in women
• Delayed puberty and stunted growth in pediatric patients
• Overeating, obesity, and sleepiness

Imaging and radiology tests for diagnosing craniopharyngiomas

The doctor may also recommend:

• A neurologic exam to evaluate vision, hearing, balance, coordination, and reflexes.
• MRI or CT scans to show the size and extent of the craniopharyngioma.

Depending on your other symptoms, such as hormone and visual problems, your doctor may refer you to an endocrinologist or an ophthalmologist to further diagnose your craniopharyngioma.

Craniopharyngioma Treatments

Minimally invasive surgery

Surgery is the primary treatment for craniopharyngiomas.

Craniopharyngiomas of the skull base may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the craniopharyngioma through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time. If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.

Although the goal of the surgery is total tumor removal with pituitary function preservation, in some cases the craniopharyngioma's proximity to critical brain structures (the hypothalamus, optic chiasm, and blood vessels) makes complete removal impossible.

The Expanded Endonasal Approach gives surgeons the best view of the undersurface of the optic nerves, chiasm, and pituitary stalk, assisting them in deciding whether to leave residual tumor attached to these important structures.

In cases where the tumor has clearly invaded the pituitary gland, surgeons may also remove the pituitary gland.

Gamma Knife® radiosurgery

Gamma Knife radiosurgery is a painless treatment procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

Surgeons may use Gamma Knife radiosurgery:

• After surgery to treat residual craniopharyngioma tumors.
• At the time of tumor recurrence.

Doctors at UPMC — the nation's leading provider of Gamma Knife procedures — have used this technology to effectively treat 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

Radiation therapy

In instances where it's not safe to remove a craniopharyngioma tumor completely, radiation may follow surgery as the next preferred treatment.

Radiation therapy for residual craniopharyngioma tumors:

• Eradicates the remaining tumor cells.
• Has success rates on par with those of complete tumor removal.

Intracavitary irradiation with phosphorus-32

Intracavitary P-32 is used for primarily cystic tumors.