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Updated: Aug 4, 2025

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Giant Craniopharyngioma.

Ali Alkhaibary1, Ahoud Alharbi1, Sami Khairy1

  • 1College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.

World Neurosurgery
|March 30, 2023
PubMed
Summary

This case study details a rare giant craniopharyngioma in a child, presenting with significant neurological symptoms. Surgical resection was performed, highlighting the challenges of managing such large tumors.

Keywords:
HugeHydrocephalusVisual disturbance

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Area of Science:

  • Pediatric Neurosurgery
  • Neuro-oncology
  • Radiology

Background:

  • Craniopharyngiomas are rare tumors typically arising in the suprasellar region.
  • Giant craniopharyngiomas, defined by large dimensions, are exceptionally uncommon, especially in pediatric patients.

Observation:

  • A 6-year-old girl presented with a 7-month history of headache, vomiting, visual disturbances, and hearing loss.
  • Neurologic examination revealed facial nerve palsy, pupillary asymmetry, papilledema, and unsteady gait.
  • Brain MRI showed a giant multiloculated suprasellar cystic lesion compressing the brainstem and causing hydrocephalus.

Findings:

  • Histopathology confirmed the lesion as an adamantinomatous craniopharyngioma.
  • The tumor measured 9.7 × 10.5 × 7.6 cm, extending into multiple cranial fossae.
  • Surgical management involved external ventricular drain insertion and tumor resection.

Implications:

  • This case underscores the rare occurrence and significant mass effect of giant craniopharyngiomas in children.
  • Early diagnosis and aggressive surgical management are crucial for favorable outcomes.
  • Further research into the specific characteristics and optimal treatment of giant craniopharyngiomas is warranted.