Craniopharyngiomas Invading the Ventricular System: A Systematic Review

Area of Science:

• Neurosurgery
• Oncology
• Cerebrospinal Fluid Dynamics

Background:

• Craniopharyngiomas invading the ventricular system (CP-Vs) are rare and present significant surgical challenges.
• These tumors predominantly affect the third ventricle.

Purpose of the Study:

• To systematically review the literature on CP-Vs.
• To analyze clinico-radiological features, management strategies, and treatment outcomes.

Main Methods:

• Comprehensive literature search of major databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane).
• Inclusion of 73 studies with 407 patients diagnosed with CP-Vs.
• Analysis of clinical data, surgical approaches (open vs. endoscopic), and outcomes.

Main Results:

• Most patients were male, presenting with headache and endocrine disorders.
• Adamantinomatous tumors were most common, often with cystic components.
• Gross-total resection was achieved in 62.9% of cases. Persistent complications like diabetes insipidus and panhypopituitarism occurred in 178 patients.
• Symptom improvement was observed in 88% of cases, with a 23.1% recurrence rate.
• Median overall survival was significantly longer after endoscopic resection (p=0.019).

Conclusions:

• CP-Vs are uncommon and surgically challenging tumors.
• Both open and endoscopic resection are feasible, with patient-tailored approach selection being critical.
• Minimizing complication risks and optimizing outcomes necessitate careful consideration of surgical techniques.