Minimally Invasive Management of Adamantinomatous Intraventricular Craniopharyngiomas: A Two-Case Series

Intraventricular craniopharyngiomas (IVCPs) are rare intracranial tumors that pose significant therapeutic challenges due to their deep-seated location, close relationship with critical neurovascular structures, and high risk of treatment-related morbidity. We report two adult cases of adamantinomatous intraventricular craniopharyngiomas, a histological subtype that is uncommon among intraventricular lesions, managed at the Neurosurgery Department of Mohammed VI University Hospital in Casablanca, Morocco. Both patients underwent endoscopic transventricular tumor resection followed by adjuvant Gamma Knife radiosurgery for residual tumor components. Postoperative outcomes were favorable, with improvement of presenting symptoms and preservation of visual, endocrine, and cognitive functions, allowing return to professional activities. After a follow-up period of 24 months in Case 1 and 30 months in Case 2, follow-up imaging demonstrated stable residual lesions without radiological progression. These cases suggest that a minimally invasive strategy combining endoscopic surgery and stereotactic radiosurgery may provide effective tumor control while minimizing neurological and endocrine morbidity in selected patients with intraventricular craniopharyngiomas and are discussed in light of current literature regarding their epidemiology, clinical presentation, radiological features, therapeutic strategies, and prognosis.