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Surgical management of craniopharyngiomas in the pediatric population
1Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. gzada@usc.edu
Insights
Surgical management is key for pediatric craniopharyngiomas (CPs), a common brain tumor type. This review details surgical approaches, goals, and outcomes for optimizing long-term patient survival and quality of life.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Neuro-oncology
Background:
- Craniopharyngiomas (CPs) are benign, locally aggressive neoplasms.
- CPs account for approximately 10% of pediatric brain tumors.
- These tumors can cause significant morbidity in children.
Purpose of the Study:
- To review the role of surgical management for pediatric craniopharyngiomas.
- To discuss goals and techniques of selected surgical approaches.
- To summarize benefits, pitfalls, and outcomes of different surgical strategies.
Main Methods:
- Literature review of surgical management for pediatric CPs.
- Analysis of transcranial and transsphenoidal approaches.
- Evaluation of the rationale, timing, and appropriateness of interventions.
Main Results:
- Surgical intervention is an important component of CP treatment.
- Realistic goals must be established before surgery.
- Various surgical approaches exist, each with specific benefits and risks.
Conclusions:
- Long-term, multimodal management by an interdisciplinary team is crucial.
- Surgery for CPs requires careful judgment regarding timing and aggressiveness.
- Optimized management can lead to a chronic, survivable condition with functional adult livelihood.
Background:
Craniopharyngiomas (CPs) are benign, locally aggressive neoplasms that comprise approximately 10% of pediatric brain tumors. The role of surgical management for CPs is discussed in this review.
Methods:
A review of the goals and techniques associated with selected surgical approaches for the treatment of CPs in the pediatric population is provided.
Results:
CPs may be a cause of significant morbidity in children, requiring long-term, multimodal management by a team of specialists in order to optimize patient outcomes. Surgical intervention for CPs remains an important component of treatment, and depends upon establishing realistic and well-defined goals prior to any operation. Many transcranial and transsphenoidal approaches are available for approaching and resecting CPs. A summary of the rationale behind the timing and appropriateness of various surgical approaches, as well as associated benefits, pitfalls, and outcomes, is provided in this review.
Conclusion:
Consistent longitudinal management by an interdisciplinary team can alter the treatment course in patients with CPs from a debilitating, morbid or lethal condition to a chronic, survivable disease with functional adult livelihood. Excellent outcomes in children with CPs are obtained only by close, frequent monitoring and by developing a keen sense of judgment regarding the appropriateness, timing and aggressiveness of any particular intervention.
