gms | German Medical Science

ESBS 2005: Skull Base Surgery: An Interdisciplinary Challenge
7th Congress of the European Skull Base Society held in association with
the 13th Congress of the German Society of Skull Base Surgery

18. - 21.05.2005, Fulda, Germany

New developed craniopharyngioma after a normal CT

Meeting Contribution

  • G. García-Fructuoso - Department of Neurosurgery, Hospital Universitari del Mar, Barcelona, Spain
  • E. Galitó - Department of Neurosurgery, Hospital Universitari del Mar, Barcelona, Spain
  • J. Prim - Department of Neurosurgery, Hospital Universitari del Mar, Barcelona, Spain
  • D. Manzano-López - Department of Neurosurgery, Hospital Universitari del Mar, Barcelona, Spain
  • F. Alameda - Department of Pathology, Hospital Universitari del Mar, Barcelona, Spain

ESBS 2005: Skull Base Surgery: An Interdisciplinary Challenge. 7th Congress of the European Skull Base Society held in association with the 13th Congress of the German Society of Skull Base Surgery. Fulda, 18.-21.05.2005. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc05esbs42

DOI: 10.3205/05esbs42, URN: urn:nbn:de:0183-05esbs428

Published: January 27, 2009

© 2009 García-Fructuoso et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Case report

A 63-year-old woman presented with worsening of her common headache and visual impairment, with severe visual acuity decrease in right eye and superior temporal quadrantanopsia in left eye. She has been followed for almost 20 years for episodes compatible with epileptic attacks. A brain CT, without contrast, performed 8 years before present episode was considered normal. Present MRI revealed a supra and retrosellar mass that was surgically approached. The lesion was a well delimited extra-axial mass partially solid and partially cystic, filled with a yellow fluid and cholesterol crystals. Pathological study was compatible with craniopharyngioma.

Discussion

Craniopharyngiomas are histologically benign tumors that are thought to arise from embryonic remnants of Rathke’s pouch and sac and manifest clinically after a steady growth that begins in fetal life. It’s difficult to understand how the tumor reported was not detected 8 years before by a CT; we know that MRI, specially in the sagittal plane, is thought to be the most sensitive test so perhaps it was there but not in a volume to be detected and, certainly, it has grown enough in that time to become visible and symptomatic. This kind of growing is remarkable in such an indolent tumor as this is believed to be. We should suppose that this tumor has originated de novo, having found some precedent cases in the literature. Some authors have said that this kind of tumor may have been dormant through the patient’s lifetime and suddenly some factor or cellullar mutation may have trigger the tumor’s growth.

We believe this case bring out attention to a further understanding of the natural history of these tumors and perhaps this kind of knowledge may lead to advances in the therapy, difficult nowadays.


References

1.
Arginteanu MS, Haghe K, Zimmerman R, et al. Craniopharyngioma arising de novo in middle age. Case report. J Neurosurg. 1997;86:1046-8.
2.
Pascual-Piazuelo MC, Bestué-Cardiel M, Serran-Ponz M. Estudio epidemiologico de craneofaringiomas en Aragon y La Rioja. Rev Neurol. 2002;34:796.
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Jain SK, Chopra S, Mathur P. Craniopharyngioma in a 82-year-old male. Neurol India. 2003;51:133-4.