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Updated: Oct 22, 2025

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Primary ectopic orbital craniopharyngioma.

Francesca Vitulli1, Elena D'Avella2, Domenico Solari2

  • 1Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Policlinico Federico II University Hospital, Via Sergio Pansini, 5, 80131, Napoli, Italy. vitullifrancesca@gmail.com.

Acta Neurochirurgica
|September 1, 2021
PubMed
Summary

This study details the first reported case of a primary ectopic craniopharyngioma (a rare brain tumor) found within the orbit. The tumor presented in a 15-year-old with orbital symptoms, successfully treated via an endoscopic approach.

Keywords:
CraniopharyngiomasEctopicEndoscopic eyelid approachOrbit

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Area of Science:

  • Neuro-oncology
  • Ophthalmology
  • Endocrinology

Background:

  • Craniopharyngiomas (CP) are rare tumors typically found in the sellar-suprasellar region.
  • Ectopic CPs outside this region are uncommon, usually resulting from tumor spread.
  • Primary ectopic CPs are exceptionally rare, with no prior orbital cases documented.

Observation:

  • A 15-year-old presented with progressive right eye ptosis, proptosis, and retro-orbital pain.
  • MRI revealed a cystic lesion in the superolateral orbit, distinct from the intraconal space.
  • No intracranial involvement was detected, suggesting a primary orbital origin.

Findings:

  • The case represents the first documented instance of a primary ectopic craniopharyngioma originating within the orbit.
  • An endoscopic transorbital eyelid approach was successfully utilized for tumor resection.
  • Histopathological analysis confirmed the diagnosis of a primary ectopic craniopharyngioma.

Implications:

  • This finding expands the known anatomical spectrum for primary craniopharyngioma development.
  • Highlights the importance of considering ectopic origins for orbital masses, even without intracranial extension.
  • Suggests endoscopic transorbital surgery as a viable approach for such rare orbital tumors.