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Craniopharyngioma.
Nature Reviews Disease Primers ( IF 76.9 ) Pub Date : 2019-11-07 , DOI: 10.1038/s41572-019-0125-9
Hermann L Müller 1 , Thomas E Merchant 2 , Monika Warmuth-Metz 3 , Juan-Pedro Martinez-Barbera 4 , Stephanie Puget 5
Affiliation  

Craniopharyngiomas are rare malformational tumours of low histological malignancy arising along the craniopharyngeal duct. The two histological subtypes, adamantinomatous craniopharyngioma (ACP) and papillary craniopharyngioma (PCP), differ in genesis and age distribution. ACPs are diagnosed with a bimodal peak of incidence (5-15 years and 45-60 years), whereas PCPs are restricted to adults mainly in the fifth and sixth decades of life. ACPs are driven by somatic mutations in CTNNB1 (encoding β-catenin) that affect β-catenin stability and are predominantly cystic in appearance. PCPs frequently harbour somatic BRAFV600E mutations and are typically solid tumours. Clinical manifestations due to increased intracranial pressure, visual impairment and endocrine deficiencies should prompt imaging investigations, preferentially MRI. Treatment comprises neurosurgery and radiotherapy; intracystic chemotherapy is used in monocystic ACP. Although long-term survival is high, quality of life and neuropsychological function are frequently impaired due to the close anatomical proximity to the optic chiasm, hypothalamus and pituitary gland. Indeed, hypothalamic involvement and treatment-related hypothalamic lesions frequently result in hypothalamic obesity, physical fatigue and psychosocial deficits. Given the rarity of these tumours, efforts to optimize infrastructure and international collaboration should be research priorities.

中文翻译:

 颅咽管瘤。


颅咽管瘤是沿颅咽管产生的罕见的低度组织恶性的畸形肿瘤。两种组织学亚型,即金刚质瘤性颅咽管瘤(ACP)和乳头状颅咽管瘤(PCP),在起源和年龄分布上有所不同。 ACP 被诊断为双峰发病率高峰(5-15 岁和 45-60 岁),而 PCP 仅限于主要在 50 岁和 60 岁的成年人。 ACP 由 CTNNB1(编码 β-连环蛋白)的体细胞突变驱动,影响 β-连环蛋白的稳定性,并且外观主要呈囊性。 PCP 经常携带体细胞 BRAFV600E 突变,通常是实体瘤。由于颅内压增高、视力障碍和内分泌缺陷引起的临床表现应立即进行影像学检查,优先进行 MRI。治疗包括神经外科手术和放射治疗;囊内化疗用于单囊 ACP。尽管长期生存率很高,但由于在解剖学上靠近视交叉、下丘脑和垂体,生活质量和神经心理功能经常受到损害。事实上,下丘脑受累和治疗相关的下丘脑病变经常导致下丘脑肥胖、身体疲劳和心理缺陷。鉴于这些肿瘤的罕见性,优化基础设施和国际合作应成为研究重点。
更新日期:2019-11-07
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