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Surgical management of craniopharyngiomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section

  • Review Article - Pituitaries
  • Published:
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Abstract

Background and objective

Craniopharyngiomas are locally aggressive neuroepithelial tumors infiltrating nearby critical neurovascular structures. The majority of published surgical series deal with childhood-onset craniopharyngiomas, while the optimal surgical management for adult-onset tumors remains unclear. The aim of this paper is to summarize the main principles defining the surgical strategy for the management of craniopharyngiomas in adult patients through an extensive systematic literature review in order to formulate a series of recommendations.

Material and methods

The MEDLINE database was systematically reviewed (January 1970–February 2019) to identify pertinent articles dealing with the surgical management of adult-onset craniopharyngiomas. A summary of literature evidence was proposed after discussion within the EANS skull base section.

Results

The EANS task force formulated 13 recommendations and 4 suggestions. Treatment of these patients should be performed in tertiary referral centers. The endonasal approach is presently recommended for midline craniopharyngiomas because of the improved GTR and superior endocrinological and visual outcomes. The rate of CSF leak has strongly diminished with the use of the multilayer reconstruction technique. Transcranial approaches are recommended for tumors presenting lateral extensions or purely intraventricular. Independent of the technique, a maximal but hypothalamic-sparing resection should be performed to limit the occurrence of postoperative hypothalamic syndromes and metabolic complications. Similar principles should also be applied for tumor recurrences. Radiotherapy or intracystic agents are alternative treatments when no further surgery is possible. A multidisciplinary long-term follow-up is necessary.

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References

  1. Abou-Al-Shaar H, Zaidi HA, Cote DJ, Laws ER Jr (2017) Bolstering the Nasoseptal Flap Using Sphenoid Sinus Fat Packing: A Technical Case Report. World neurosurgery 99:813 e811–813 e815

    Google Scholar 

  2. Alli S, Isik S, Rutka JT (2016) Microsurgical removal of craniopharyngioma: endoscopic and transcranial techniques for complication avoidance. J Neuro-Oncol 130:299–307

    Google Scholar 

  3. Al-Mefty O, Ayoubi S, Kadri PA (2008) The petrosal approach for the resection of retrochiasmatic craniopharyngiomas. Neurosurgery 62:ONS331–ONS335 discussion ONS335-336

    PubMed  Google Scholar 

  4. Apra C, Enachescu C, Lapras V, Raverot G, Jouanneau E (2019) Is gross total resection reasonable in adults with craniopharyngiomas with hypothalamic involvement? World neurosurgery 129:e803–e811

    PubMed  Google Scholar 

  5. Astradsson A, Munck Af Rosenschold P, Feldt-Rasmussen U, Poulsgaard L, Wiencke AK, Ohlhues L, Engelholm SA, Broholm H, Hansen Moller E, Klose M, Roed H, Juhler M (2017) Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort. Acta Oncol 56:415–421

    PubMed  Google Scholar 

  6. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O'Connell D, Oxman AD, Phillips B, Schunemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr, Zaza S, Group GW (2004) Grading quality of evidence and strength of recommendations. Bmj 328:1490

    PubMed  Google Scholar 

  7. Balde NM, Diallo MM, Poirier JY, Sow MS, Brassier G, Lorcy Y (2007) Long-term outcome of the adult onset craniopharyngiomas. Ann Endocrinol 68:186–190

    CAS  Google Scholar 

  8. Bao Y, Pan J, Qi ST, Lu YT, Peng JX (2016) Origin of craniopharyngiomas: implications for growth pattern, clinical characteristics, and outcomes of tumor recurrence. J Neurosurg 125:24–32

    CAS  PubMed  Google Scholar 

  9. Bartels U, Laperriere N, Bouffet E, Drake J (2012) Intracystic therapies for cystic craniopharyngioma in childhood. Front Endocrinol 3:39

    Google Scholar 

  10. Bergthorsdottir R, Leonsson-Zachrisson M, Oden A, Johannsson G (2006) Premature mortality in patients with Addison’s disease: a population-based study. J Clin Endocrinol Metab 91:4849–4853

    CAS  PubMed  Google Scholar 

  11. Bialer OY, Goldenberg-Cohen N, Toledano H, Snir M, Michowiz S (2013) Retinal NFL thinning on OCT correlates with visual field loss in pediatric craniopharyngioma. Canadian journal of ophthalmology Journal canadien d’ophtalmologie 48:494–499

    PubMed  Google Scholar 

  12. Brastianos PK, Shankar GM, Gill CM, Taylor-Weiner A, Nayyar N, Panka DJ, Sullivan RJ, Frederick DT, Abedalthagafi M, Jones PS, Dunn IF, Nahed BV, Romero JM, Louis DN, Getz G, Cahill DP, Santagata S, Curry WT Jr, Barker FG 2nd (2016) Dramatic response of BRAF V600E mutant papillary craniopharyngioma to targeted therapy. J Natl Cancer Inst 108(2). https://doi.org/10.1093/jnci/djv310

  13. Brouwers MC, Kerkvliet K, Spithoff K, ANS C (2016) The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines. Bmj 352:i1152

    PubMed  PubMed Central  Google Scholar 

  14. Bulow B, Attewell R, Hagmar L, Malmstrom P, Nordstrom CH, Erfurth EM (1998) Postoperative prognosis in craniopharyngioma with respect to cardiovascular mortality, survival, and tumor recurrence. J Clin Endocrinol Metab 83:3897–3904

    CAS  PubMed  Google Scholar 

  15. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551

    CAS  PubMed  Google Scholar 

  16. Campbell PG, McGettigan B, Luginbuhl A, Yadla S, Rosen M, Evans JJ (2010) Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas. Neurosurg Focus 28:E8

    PubMed  Google Scholar 

  17. Cappabianca P, Cavallo LM (2012) The evolving role of the transsphenoidal route in the management of craniopharyngiomas. World neurosurgery 77:273–274

    PubMed  Google Scholar 

  18. Cappabianca P, Cavallo LM, de Divitiis E (2004) Endoscopic endonasal transsphenoidal surgery. Neurosurgery 55:933–940 discussion 940-931

    PubMed  Google Scholar 

  19. Carpentieri SC, Waber DP, Scott RM, Goumnerova LC, Kieran MW, Cohen LE, Kim F, Billett AL, Tarbell NJ, Pomeroy SL (2001) Memory deficits among children with craniopharyngiomas. Neurosurgery 49:1053–1057 discussion 1057-1058

    CAS  PubMed  Google Scholar 

  20. Casanueva FF, Barkan AL, Buchfelder M, Klibanski A, Laws ER, Loeffler JS, Melmed S, Mortini P, Wass J, Giustina A, Pituitary Society EGoPT (2017) Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): a Pituitary Society statement. Pituitary 20:489–498

    PubMed  PubMed Central  Google Scholar 

  21. Cavalheiro S, Dastoli PA, Silva NS, Toledo S, Lederman H, da Silva MC (2005) Use of interferon alpha in intratumoral chemotherapy for cystic craniopharyngioma. Childs Nerv Syst 21(8-9):719–724

    CAS  PubMed  Google Scholar 

  22. Cavallo LM, Cappabianca P (2014) Craniopharyngiomas: infradiaphragmatic and supradiaphragmatic type and their management in modern times. World neurosurgery 81:683–684

    PubMed  Google Scholar 

  23. Cavallo LM, Prevedello DM, Solari D, Gardner PA, Esposito F, Snyderman CH, Carrau RL, Kassam AB, Cappabianca P (2009) Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas. J Neurosurg 111:578–589

    PubMed  Google Scholar 

  24. Cavallo LM, Solari D, Esposito F, Cappabianca P (2013) The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle. Neurosurg Rev 36:27–37 discussion 38

    PubMed  Google Scholar 

  25. Cavallo LM, Frank G, Cappabianca P, Solari D, Mazzatenta D, Villa A, Zoli M, D'Enza AI, Esposito F, Pasquini E (2014) The endoscopic endonasal approach for the management of craniopharyngiomas: a series of 103 patients. J Neurosurg 121:100–113

    PubMed  Google Scholar 

  26. Cavallo LM, Solari D, Esposito F, Villa A, Minniti G, Cappabianca P (2014) The role of the endoscopic endonasal route in the management of craniopharyngiomas. World neurosurgery 82:S32–S40

    PubMed  Google Scholar 

  27. Chung WY, Pan DH, Shiau CY, Guo WY, Wang LW (2000) Gamma knife radiosurgery for craniopharyngiomas. J Neurosurg 93(Suppl 3):47–56

    PubMed  Google Scholar 

  28. Conger A, Zhao F, Wang X, Eisenberg A, Griffiths C, Esposito F, Carrau RL, Barkhoudarian G, Kelly DF (2018) Evolution of the graded repair of CSF leaks and skull base defects in endonasal endoscopic tumor surgery: trends in repair failure and meningitis rates in 509 patients. J Neurosurg 130(3):861–875. https://doi.org/10.3171/2017.11.JNS172141

  29. Crowley RK, Hamnvik OP, O'Sullivan EP, Behan LA, Smith D, Agha A, Thompson CJ (2010) Morbidity and mortality in patients with craniopharyngioma after surgery. Clin Endocrinol 73:516–521

    CAS  Google Scholar 

  30. Crowley RK, Woods C, Fleming M, Rogers B, Behan LA, O'Sullivan EP, Kane T, Agha A, Smith D, Costello RW, Thompson CJ (2011) Somnolence in adult craniopharyngioma patients is a common, heterogeneous condition that is potentially treatable. Clin Endocrinol 74:750–755

    CAS  Google Scholar 

  31. Dandurand C, Sepehry AA, Asadi Lari MH, Akagami R, Gooderham P (2017) Adult craniopharyngioma: case series, systematic review, and meta-analysis. Neurosurgery

  32. Dastoli PA, Nicacio JM, Silva NS, Capellano AM, Toledo SR, Ierardi D, Cavalheiro S (2011) Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon. Arq Neuropsiquiatr 69:50–55

    PubMed  Google Scholar 

  33. Davies MJ, King TT, Metcalfe KA, Monson JP (1997) Intraventricular craniopharyngioma: a long-term follow-up of six cases. Br J Neurosurg 11:533–541

    CAS  PubMed  Google Scholar 

  34. de Divitiis E, Cappabianca P, Cavallo LM, Esposito F, de Divitiis O, Messina A (2007) Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas. Neurosurgery 61:219–227 discussion 228

    PubMed  Google Scholar 

  35. de Divitiis E, Cavallo LM, Cappabianca P, Esposito F (2007) Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors: Part 2. Neurosurgery 60:46–58 discussion 58-49

    PubMed  Google Scholar 

  36. Dhandapani S, Singh H, Negm HM, Cohen S, Souweidane MM, Greenfield JP, Anand VK, Schwartz TH (2017) Endonasal endoscopic reoperation for residual or recurrent craniopharyngiomas. J Neurosurg 126:418–430

    PubMed  Google Scholar 

  37. Dho YS, Kim YH, Se YB, Han DH, Kim JH, Park CK, Wang KC, Kim DG (2017) Endoscopic endonasal approach for craniopharyngioma: the importance of the relationship between pituitary stalk and tumor. J Neurosurg:1–9

  38. Donnet A, Schmitt A, Dufour H, Grisoli F (1999) Neuropsychological follow-up of twenty two adult patients after surgery for craniopharyngioma. Acta Neurochir 141:1049–1054

    CAS  PubMed  Google Scholar 

  39. Du C, Feng CY, Yuan XR, Liu Q, Peng ZF, Jiang XJ, Li XJ, Xiao GL, Li YF, Xiong T (2016) Microsurgical management of craniopharyngiomas via a unilateral subfrontal approach: a retrospective study of 177 continuous cases. World neurosurgery 90:454–468

    PubMed  Google Scholar 

  40. Dusick JR, Esposito F, Kelly DF, Cohan P, DeSalles A, Becker DP, Martin NA (2005) The extended direct endonasal transsphenoidal approach for nonadenomatous suprasellar tumors. J Neurosurg 102:832–841

    PubMed  Google Scholar 

  41. Elliott RE, Jane JA Jr, Wisoff JH (2011) Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery 69:630–643 discussion 643

    PubMed  Google Scholar 

  42. Eloy JA, Kuperan AB, Choudhry OJ, Harirchian S, Liu JK (2012) Efficacy of the pedicled nasoseptal flap without cerebrospinal fluid (CSF) diversion for repair of skull base defects: incidence of postoperative CSF leaks. International forum of allergy & rhinology 2:397–401

    Google Scholar 

  43. Erfurth EM, Bulow B, Svahn-Tapper G, Norrving B, Odh K, Mikoczy Z, Bjork J, Hagmar L (2002) Risk factors for cerebrovascular deaths in patients operated and irradiated for pituitary tumors. J Clin Endocrinol Metab 87:4892–4899

    CAS  PubMed  Google Scholar 

  44. Erfurth EM, Holmer H, Fjalldal SB (2013) Mortality and morbidity in adult craniopharyngioma. Pituitary 16:46–55

    PubMed  Google Scholar 

  45. Evans JJ, Kenning TJ (2014) Craniopharyngiomas; comprehensive diagnosis, treatment and outcome. Elsevier, Oxford

    Google Scholar 

  46. Fahlbusch R, Hofmann BM (2008) Surgical management of giant craniopharyngiomas. Acta Neurochir 150:1213–1226

    CAS  PubMed  Google Scholar 

  47. Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:237–250

    CAS  PubMed  Google Scholar 

  48. Fang Y, Cai BW, Zhang H, Liu W, Wu B, Xu JG, You C (2012) Intracystic bleomycin for cystic craniopharyngiomas in children. The Cochrane database of systematic reviews:CD008890

  49. Fernandez-Miranda JC, Gardner PA, Snyderman CH, Devaney KO, Strojan P, Suarez C, Genden EM, Rinaldo A, Ferlito A (2012) Craniopharyngioma: a pathologic, clinical, and surgical review. Head & neck 34:1036–1044

    Google Scholar 

  50. Fjalldal S, Holmer H, Rylander L, Elfving M, Ekman B, Osterberg K, Erfurth EM (2013) Hypothalamic involvement predicts cognitive performance and psychosocial health in long-term survivors of childhood craniopharyngioma. J Clin Endocrinol Metab 98:3253–3262

    CAS  PubMed  Google Scholar 

  51. Fjalldal S, Follin C, Svard D, Rylander L, Gabery S, Petersen A, van Westen D, Sundgren PC, Bjorkman-Burtscher IM, Latt J, Ekman B, Johanson A, Erfurth EM (2018) Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma. European journal of endocrinology / European Federation of Endocrine Societies 178:577–587

    CAS  Google Scholar 

  52. Forbes JA, Ordonez-Rubiano EG, Tomasiewicz HC, Banu MA, Younus I, Dobri GA, Phillips CD, Kacker A, Cisse B, Anand VK, Schwartz TH (2018) Endonasal endoscopic transsphenoidal resection of intrinsic third ventricular craniopharyngioma: surgical results. J Neurosurg:1–11

  53. Fortes FS, Carrau RL, Snyderman CH, Kassam A, Prevedello D, Vescan A, Mintz A, Gardner P (2007) Transpterygoid transposition of a temporoparietal fascia flap: a new method for skull base reconstruction after endoscopic expanded endonasal approaches. Laryngoscope 117:970–976

    PubMed  Google Scholar 

  54. Fortes FS, Carrau RL, Snyderman CH, Prevedello D, Vescan A, Mintz A, Gardner P, Kassam AB (2007) The posterior pedicle inferior turbinate flap: a new vascularized flap for skull base reconstruction. Laryngoscope 117:1329–1332

    PubMed  Google Scholar 

  55. Foschi M, Sambati L, Zoli M, Pierangeli G, Cecere A, Mignani F, Barletta G, Sturiale C, Faustini-Fustini M, Milanese L, Cortelli P, Mazzatenta D, Provini F (2017) Site and type of craniopharyngiomas impact differently on 24-hour circadian rhythms and surgical outcome. A neurophysiological evaluation Autonomic neuroscience : basic & clinical 208:126–130

    CAS  Google Scholar 

  56. Fournier-Goodnight AS, Ashford JM, Merchant TE, Boop FA, Indelicato DJ, Wang L, Zhang H, Conklin HM (2017) Neurocognitive functioning in pediatric craniopharyngioma: performance before treatment with proton therapy. J Neuro-Oncol 134:97–105

    Google Scholar 

  57. Frank G, Pasquini E, Doglietto F, Mazzatenta D, Sciarretta V, Farneti G, Calbucci F (2006) The endoscopic extended transsphenoidal approach for craniopharyngiomas. Neurosurgery 59:ONS75–ONS83 discussion ONS75-83

    PubMed  Google Scholar 

  58. Friedman MA, Meyers CA, Sawaya R (2008) Neuropsychological effects of third ventricle tumor surgery. Neurosurgery 62:1093–1100

    PubMed  Google Scholar 

  59. Frio F, Solari D, Cavallo LM, Cappabianca P, Raverot G, Jouanneau E (2019) Ommaya Reservoir System for the Treatment of Cystic Craniopharyngiomas: Surgical Results in a Series of 11 Adult Patients and Review of the Literature. World neurosurgery

  60. Gardner PA, Kassam AB, Snyderman CH, Carrau RL, Mintz AH, Grahovac S, Stefko S (2008) Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg 109:6–16

    PubMed  Google Scholar 

  61. Gardner PA, Prevedello DM, Kassam AB, Snyderman CH, Carrau RL, Mintz AH (2008) The evolution of the endonasal approach for craniopharyngiomas. J Neurosurg 108:1043–1047

    PubMed  Google Scholar 

  62. Gerganov V, Metwali H, Samii A, Fahlbusch R, Samii M (2014) Microsurgical resection of extensive craniopharyngiomas using a frontolateral approach: operative technique and outcome. J Neurosurg 120:559–570

    PubMed  Google Scholar 

  63. Gonzalez LF, Crawford NR, Horgan MA, Deshmukh P, Zabramski JM, Spetzler RF (2002) Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach. Neurosurgery 50:550–555 discussion 555-557

    PubMed  Google Scholar 

  64. Gopalan R, Dassoulas K, Rainey J, Sherman JH, Sheehan JP (2008) Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas. Neurosurg Focus 24:E5

    PubMed  Google Scholar 

  65. Graffeo CS, Dietrich AR, Grobelny B, Zhang M, Goldberg JD, Golfinos JG, Lebowitz R, Kleinberg D, Placantonakis DG (2014) A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors. Pituitary 17:349–356

    PubMed  PubMed Central  Google Scholar 

  66. Gupta S, Bi WL, Giantini Larsen A, Al-Abdulmohsen S, Abedalthagafi M, Dunn IF (2018) Craniopharyngioma: a roadmap for scientific translation. Neurosurg Focus 44:E12

    PubMed  Google Scholar 

  67. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schunemann HJ, Group GW (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Bmj 336:924–926

    PubMed  PubMed Central  Google Scholar 

  68. Hackman T, Chicoine MR, Uppaluri R (2009) Novel application of the palatal island flap for endoscopic skull base reconstruction. Laryngoscope 119:1463–1466

    PubMed  Google Scholar 

  69. Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:1882–1886

    PubMed  Google Scholar 

  70. Hald JK, Eldevik OP, Quint DJ, Chandler WF, Kollevold T (1996) Pre- and postoperative MR imaging of craniopharyngiomas. Acta Radiol 37:806–812

    CAS  PubMed  Google Scholar 

  71. Harvey RJ, Parmar P, Sacks R, Zanation AM (2012) Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 122:452–459

    PubMed  Google Scholar 

  72. Hasegawa T, Kondziolka D, Hadjipanayis CG, Lunsford LD (2004) Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery 54:813–820 discussion 820-812

    PubMed  Google Scholar 

  73. Himes BT, Ruff MW, Van Gompel JJ, Park SS, Galanis E, Kaufmann TJ, Uhm JH (2018) Recurrent papillary craniopharyngioma with BRAF V600E mutation treated with dabrafenib: case report. J Neurosurg 1-5. https://doi.org/10.3171/2017.11.JNS172373

  74. Hoffman HJ (1994) Surgical management of craniopharyngioma. Pediatr Neurosurg 21(Suppl 1):44–49

    PubMed  Google Scholar 

  75. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76:47–52

    CAS  PubMed  Google Scholar 

  76. Holmer H, Ekman B, Bjork J, Nordstom CH, Popovic V, Siversson A, Erfurth EM (2009) Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy. European journal of endocrinology / European Federation of Endocrine Societies 161:671–679

    CAS  Google Scholar 

  77. Holmer H, Pozarek G, Wirfalt E, Popovic V, Ekman B, Bjork J, Erfurth EM (2010) Reduced energy expenditure and impaired feeding-related signals but not high energy intake reinforces hypothalamic obesity in adults with childhood onset craniopharyngioma. J Clin Endocrinol Metab 95:5395–5402

    CAS  PubMed  Google Scholar 

  78. Honegger J, Barocka A, Sadri B, Fahlbusch R (1998) Neuropsychological results of craniopharyngioma surgery in adults: a prospective study. Surg Neurol 50:19–28 discussion 28-19

    CAS  PubMed  Google Scholar 

  79. Honegger J, Buchfelder M, Fahlbusch R (1999) Surgical treatment of craniopharyngiomas: endocrinological results. J Neurosurg 90:251–257

    CAS  PubMed  Google Scholar 

  80. Hori T, Kawamata T, Amano K, Aihara Y, Ono M, Miki N (2010) Anterior interhemispheric approach for 100 tumors in and around the anterior third ventricle. Neurosurgery 66:65–74

    PubMed  Google Scholar 

  81. Ikeda H, Gotoh H, Watanabe K (2012) Outcome of endoscopy-assisted microscopic extended transsphenoidal surgery for suprasellar adult craniopharyngiomas. Front Endocrinol 3:25

    Google Scholar 

  82. Ishii Y, Tahara S, Teramoto A, Morita A (2014) Endoscopic endonasal skull base surgery: advantages, limitations, and our techniques to overcome cerebrospinal fluid leakage: technical note. Neurol Med Chir 54:983–990

    Google Scholar 

  83. Iwasaki K, Kondo A, Takahashi JB, Yamanobe K (1992) Intraventricular craniopharyngioma: report of two cases and review of the literature. Surg Neurol 38:294–301

    CAS  PubMed  Google Scholar 

  84. Jacobsen MF, Thomsen ASS, Bach-Holm D, Doroudian G, Nissen KR, Fugleholm K, Poulsgaard L, Siersma V, Heegaard S (2018) Predictors of visual outcome in patients operated for craniopharyngioma - a Danish national study. Acta Ophthalmol 96:39–45

    PubMed  Google Scholar 

  85. Jane JA Jr, Kiehna E, Payne SC, Early SV, Laws ER Jr (2010) Early outcomes of endoscopic transsphenoidal surgery for adult craniopharyngiomas. Neurosurg Focus 28:E9

    PubMed  Google Scholar 

  86. Jasim S, Alahdab F, Ahmed AT, Tamhane S, Prokop LJ, Nippoldt TB, Murad MH (2017) Mortality in adults with hypopituitarism: a systematic review and meta-analysis. Endocrine 56:33–42

    CAS  PubMed  Google Scholar 

  87. Jeswani S, Nuno M, Wu A, Bonert V, Carmichael JD, Black KL, Chu R, King W, Mamelak AN (2016) Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal transsphenoidal resection of craniopharyngioma and related tumors: a single-institution study. J Neurosurg 124:627–638

    PubMed  Google Scholar 

  88. Jung TY, Jung S, Choi JE, Moon KS, Kim IY, Kang SS (2009) Adult craniopharyngiomas: surgical results with a special focus on endocrinological outcomes and recurrence according to pituitary stalk preservation. J Neurosurg 111:572–577

    PubMed  Google Scholar 

  89. Jung TY, Jung S, Moon KS, Kim IY, Kang SS, Kim JH (2010) Endocrinological outcomes of pediatric craniopharyngiomas with anatomical pituitary stalk preservation: preliminary study. Pediatr Neurosurg 46:205–212

    PubMed  Google Scholar 

  90. Kaptain GJ, Vincent DA, Sheehan JP, Laws ER Jr (2001) Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery 49:94–100 discussion 100-101

    CAS  PubMed  Google Scholar 

  91. Karavitaki N (2014) Management of craniopharyngiomas. J Endocrinol Investig 37:219–228

    CAS  Google Scholar 

  92. Karavitaki N, Brufani C, Warner JT, Adams CB, Richards P, Ansorge O, Shine B, Turner HE, Wass JA (2005) Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol 62:397–409

    CAS  Google Scholar 

  93. Karavitaki N, Cudlip S, Adams CB, Wass JA (2006) Craniopharyngiomas. Endocr Rev 27:371–397

    PubMed  Google Scholar 

  94. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM (2008) Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108:715–728

    PubMed  Google Scholar 

  95. Kato T, Sawamura Y, Abe H, Nagashima M (1998) Transsphenoidal-transtuberculum sellae approach for supradiaphragmatic tumours: technical note. Acta Neurochir 140:715–718 discussion 719

    CAS  PubMed  Google Scholar 

  96. Kerr EE, Jamshidi A, Carrau RL, Campbell RG, Filho LFD, Otto BA, Prevedello DM (2017) Indocyanine green fluorescence to evaluate nasoseptal flap viability in endoscopic endonasal cranial base surgery. Journal of neurological surgery. Part B, Skull base 78:408–412

    PubMed  Google Scholar 

  97. Kim J, Choe I, Bak K, Kim C, Kim N, Jang Y (2000) Transsphenoidal supradiaphragmatic intradural approach: technical note. Minimally invasive neurosurgery : MIN 43:33–37

    CAS  PubMed  Google Scholar 

  98. Kim SK, Kim YH, Park CK, Kim DG, Jung HW (2014) Extended endoscopic endonasal approach for recurrent or residual adult craniopharyngiomas. Acta Neurochir 156:1917–1922

    PubMed  Google Scholar 

  99. Kim KH, Kim YH, Dho YS, Kim JH, Hong SD, Choi JW, Seol HJ, Nam DH, Lee JI, Park CK, Kong DS (2018) Is low-lying optic chiasm an obstacle to an endoscopic endonasal approach for retrochiasmatic craniopharyngiomas? (Korean Society of Endoscopic Neurosurgery -003). World neurosurgery 114:e306–e316

    PubMed  Google Scholar 

  100. Kobayashi T (2009) Long-term results of gamma knife radiosurgery for 100 consecutive cases of craniopharyngioma and a treatment strategy. Progress in neurological surgery 22:63–76

    PubMed  Google Scholar 

  101. Kobayashi T, Kida Y, Hasegawa T (2003) Long-term results of gamma knife surgery for craniopharyngioma. Neurosurg Focus 14:e13

    PubMed  Google Scholar 

  102. Komotar RJ, Roguski M, Bruce JN (2009) Surgical management of craniopharyngiomas. J Neuro-Oncol 92:283–296

    Google Scholar 

  103. Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World neurosurgery 77:329–341

    PubMed  Google Scholar 

  104. Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World neurosurgery 77:713–724

    PubMed  Google Scholar 

  105. Konovalov AN (2014) Third ventricle craniopharyngiomas. World neurosurgery 82:1023–1025

    PubMed  Google Scholar 

  106. Kouri JG, Chen MY, Watson JC, Oldfield EH (2000) Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases Journal of neurosurgery 92:1028–1035

    CAS  PubMed  Google Scholar 

  107. Koutourousiou M, Gardner PA, Fernandez-Miranda JC, Tyler-Kabara EC, Wang EW, Snyderman CH (2013) Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients. J Neurosurg 119:1194–1207

    PubMed  Google Scholar 

  108. Laws ER Jr, Vance ML (1999) Radiosurgery for pituitary tumors and craniopharyngiomas. Neurosurg Clin N Am 10:327–336

    PubMed  Google Scholar 

  109. Leng LZ, Brown S, Anand VK, Schwartz TH (2008) “Gasket-seal” watertight closure in minimal-access endoscopic cranial base surgery. Neurosurgery 62:ONSE342–ONSE343 discussion ONSE343

    PubMed  Google Scholar 

  110. Leng LZ, Greenfield JP, Souweidane MM, Anand VK, Schwartz TH (2012) Endoscopic, endonasal resection of craniopharyngiomas: analysis of outcome including extent of resection, cerebrospinal fluid leak, return to preoperative productivity, and body mass index. Neurosurgery 70:110–123 discussion 123-114

    PubMed  Google Scholar 

  111. Li K, Lu X, Yang N, Zheng J, Huang B, Li L (2015) Association of pituitary stalk management with endocrine outcomes and recurrence in microsurgery of craniopharyngiomas: a meta-analysis. Clin Neurol Neurosurg 136:20–24

    PubMed  Google Scholar 

  112. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Bmj 339:b2700

    PubMed  PubMed Central  Google Scholar 

  113. Liu JK, Eloy JA (2012) Endoscopic endonasal transplanum transtuberculum approach for resection of retrochiasmatic craniopharyngioma. J Neurosur 32:E2

    Google Scholar 

  114. Liu JK, Cole CD, Kestle JR, Brockmeyer DL, Walker ML (2005) Cranial base strategies for resection of craniopharyngioma in children. Neurosurg Focus 18:E9

    PubMed  Google Scholar 

  115. Liu JK, Christiano LD, Gupta G, Carmel PW (2010) Surgical nuances for removal of retrochiasmatic craniopharyngiomas via the transbasal subfrontal translamina terminalis approach. Neurosurg Focus 28:E6

    PubMed  Google Scholar 

  116. Liu JK, Sevak IA, Carmel PW, Eloy JA (2016) Microscopic versus endoscopic approaches for craniopharyngiomas: choosing the optimal surgical corridor for maximizing extent of resection and complication avoidance using a personalized, tailored approach. Neurosurg Focus 41:E5

    PubMed  Google Scholar 

  117. Losa M, Pieri V, Bailo M, Gagliardi F, Barzaghi LR, Gioia L, Del Vecchio A, Bolognesi A, Mortini P (2018) Single fraction and multisession Gamma Knife radiosurgery for craniopharyngioma. Pituitary 21:499–506

    PubMed  Google Scholar 

  118. Maira G, Anile C, Rossi GF, Colosimo C (1995) Surgical treatment of craniopharyngiomas: an evaluation of the transsphenoidal and pterional approaches. Neurosurgery 36:715–724

    CAS  PubMed  Google Scholar 

  119. Maison P, Griffin S, Nicoue-Beglah M, Haddad N, Balkau B, Chanson P (2004) Metaanalysis of Blinded RP-CT (2004) Impact of growth hormone (GH) treatment on cardiovascular risk factors in GH-deficient adults: a metaanalysis of blinded, randomized, placebo-controlled trials. J Clin Endocrinol Metab 89:2192–2199

    CAS  PubMed  Google Scholar 

  120. Martinez-Barbera JP (2015) Molecular and cellular pathogenesis of adamantinomatous craniopharyngioma. Neuropathol Appl Neurobiol 41:721–732

    PubMed  PubMed Central  Google Scholar 

  121. Mascarenhas L, Moshel YA, Bayad F, Szentirmai O, Salek AA, Leng LZ, Hofstetter CP, Placantonakis DG, Tsiouris AJ, Anand VK, Schwartz TH (2014) The transplanum transtuberculum approaches for suprasellar and sellar-suprasellar lesions: avoidance of cerebrospinal fluid leak and lessons learned. World neurosurgery 82:186–195

    PubMed  Google Scholar 

  122. McLendon RE, Rosenblum MK, Bigner DD (2006) Pathology of tumors of the nervous system 7ed. Russell & Rubinstein's, London

    Google Scholar 

  123. Mediero S, Noval S, Bravo-Ljubetic L, Contreras I, Carceller F (2015) Visual outcomes, visual fields, and optical coherence tomography in paediatric craniopharyngioma. Neuro-ophthalmology 39:132–139

    PubMed  PubMed Central  Google Scholar 

  124. Meling TR, Nylen ES (1996) Growth hormone deficiency in adults: a review. Am J Med Sci 311:153–166

    CAS  PubMed  Google Scholar 

  125. Miljic D, Popovic V (2018) Metabolic syndrome in hypopituitarism. Front Horm Res 49:1–19

    PubMed  Google Scholar 

  126. Minamida Y, Mikami T, Hashi K, Houkin K (2005) Surgical management of the recurrence and regrowth of craniopharyngiomas. J Neurosurg 103:224–232

    PubMed  Google Scholar 

  127. Minniti G, Saran F, Traish D, Soomal R, Sardell S, Gonsalves A, Ashley S, Warrington J, Burke K, Mosleh-Shirazi A, Brada M (2007) Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 82:90–95

    Google Scholar 

  128. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML, Endocrine S (2011) Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1587–1609

    CAS  PubMed  Google Scholar 

  129. Moon CH, Hwang SC, Kim BT, Ohn YH, Park TK (2011) Visual prognostic value of optical coherence tomography and photopic negative response in chiasmal compression. Invest Ophthalmol Vis Sci 52:8527–8533

    PubMed  Google Scholar 

  130. Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S, Angius D, Weber G, Chiumello G, Giovanelli M (2011) Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. J Neurosurg 114:1350–1359

    PubMed  Google Scholar 

  131. Moussazadeh N, Prabhu V, Bander ED, Cusic RC, Tsiouris AJ, Anand VK, Schwartz TH (2016) Endoscopic endonasal versus open transcranial resection of craniopharyngiomas: a case-matched single-institution analysis. Neurosurg Focus 41:E7

    PubMed  Google Scholar 

  132. Mrowczynski OD, Langan ST, Rizk EB (2018) Craniopharyngiomas: a systematic review and evaluation of the current intratumoral treatment landscape. Clin Neurol Neurosurg 166:124–130

    PubMed  Google Scholar 

  133. Muller HL, Gebhardt U, Teske C, Faldum A, Zwiener I, Warmuth-Metz M, Pietsch T, Pohl F, Sorensen N, Calaminus G, Study Committee of K (2011) Post-operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow-up. European journal of endocrinology / European Federation of Endocrine Societies 165:17–24

    Google Scholar 

  134. Niranjan A, Kano H, Mathieu D, Kondziolka D, Flickinger JC, Lunsford LD (2010) Radiosurgery for craniopharyngioma. Int J Radiat Oncol Biol Phys 78:64–71

    PubMed  Google Scholar 

  135. Nishioka H, Fukuhara N, Yamaguchi-Okada M, Yamada S (2016) Endoscopic endonasal surgery for purely intrathird ventricle craniopharyngioma. World neurosurgery 91:266–271

    PubMed  Google Scholar 

  136. Nyquist GG, Anand VK, Singh A, Schwartz TH (2010) Janus flap: bilateral nasoseptal flaps for anterior skull base reconstruction. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 142:327–331

    Google Scholar 

  137. Oliver CL, Hackman TG, Carrau RL, Snyderman CH, Kassam AB, Prevedello DM, Gardner P (2008) Palatal flap modifications allow pedicled reconstruction of the skull base. Laryngoscope 118:2102–2106

    PubMed  Google Scholar 

  138. Omay SB, Almeida JP, Chen YN, Shetty SR, Liang B, Ni S, Anand VK, Schwartz TH (2017) Is the chiasm-pituitary corridor size important for achieving gross-total resection during endonasal endoscopic resection of craniopharyngiomas? J Neurosurg 129(3):642–647. https://doi.org/10.3171/2017.6.JNS163188

  139. Owen PJ, Lazarus JH (2003) Subclinical hypothyroidism: the case for treatment. Trends Endocrinol Metab 14:257–261

    CAS  PubMed  Google Scholar 

  140. Ozyurt J, Muller HL, Thiel CM (2015) A systematic review of cognitive performance in patients with childhood craniopharyngioma. J Neuro-Oncol 125:9–21

    Google Scholar 

  141. Park HR, Kshettry VR, Farrell CJ, Lee JM, Kim YH, Won TB, Han DH, Do H, Nyguist G, Rosen M, Kim DG, Evans JJ, Paek SH (2017) Clinical outcome after extended endoscopic endonasal resection of craniopharyngiomas: two-institution experience. World neurosurgery 103:465–474

    PubMed  Google Scholar 

  142. Pascual JM, Carrasco R, Prieto R, Gonzalez-Llanos F, Alvarez F, Roda JM (2008) Craniopharyngioma classification. J Neurosurg 109:1180–1182 author reply 1182-1183

    PubMed  Google Scholar 

  143. Pascual JM, Prieto R, Carrasco R (2011) Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category. Acta Neurochir 153:2403–2425 discussion 2426

    PubMed  Google Scholar 

  144. Patel MR, Taylor RJ, Hackman TG, Germanwala AV, Sasaki-Adams D, Ewend MG, Zanation AM (2014) Beyond the nasoseptal flap: outcomes and pearls with secondary flaps in endoscopic endonasal skull base reconstruction. Laryngoscope 124:846–852

    PubMed  Google Scholar 

  145. Patel VS, Thamboo A, Quon J, Nayak JV, Hwang PH, Edwards M, Patel ZM (2017) Outcomes after endoscopic endonasal resection of craniopharyngiomas in the pediatric population. World neurosurgery 108:6–14

    PubMed  Google Scholar 

  146. Pekmezci M, Louie J, Gupta N, Bloomer MM, Tihan T (2010) Clinicopathological characteristics of adamantinomatous and papillary craniopharyngiomas: University of California, San Francisco experience 1985-2005. Neurosurgery 67:1341–1349 discussion 1349

    PubMed  Google Scholar 

  147. Pereira AM, Schmid EM, Schutte PJ, Voormolen JH, Biermasz NR, van Thiel SW, Corssmit EP, Smit JW, Roelfsema F, Romijn JA (2005) High prevalence of long-term cardiovascular, neurological and psychosocial morbidity after treatment for craniopharyngioma. Clin Endocrinol 62:197–204

    Google Scholar 

  148. Pinheiro-Neto CD, Carrau RL, Prevedello DM, Fernandez-Miranda JC, Snyderman CS, Gardner PA, Kassam AB (2010) Use of acoustic Doppler sonography to ascertain the feasibility of the pedicled nasoseptal flap after prior bilateral sphenoidotomy. Laryngoscope 120:1798–1801

    PubMed  Google Scholar 

  149. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E (2004) Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 46:220–229

    PubMed  Google Scholar 

  150. Prieto R, Pascual JM, Barrios L (2015) Optic chiasm distortions caused by craniopharyngiomas: clinical and magnetic resonance imaging correlation and influence on visual outcome. World neurosurgery 83:500–529

    PubMed  Google Scholar 

  151. Prieto R, Pascual JM, Rosdolsky M, Castro-Dufourny I, Carrasco R, Strauss S, Barrios L (2016) Craniopharyngioma adherence: a comprehensive topographical categorization and outcome-related risk stratification model based on the methodical examination of 500 tumors. Neurosurg Focus 41:E13

    PubMed  Google Scholar 

  152. Prieto R, Pascual JM, Barrios L (2017) Optic chiasm distortions in craniopharyngiomas: a sign of hypothalamic involvement. Acta Neurochir 159:1533–1535

    PubMed  Google Scholar 

  153. Prieto R, Pascual JM, Barrios L (2017) Topographic diagnosis of craniopharyngiomas: the accuracy of MRI findings observed on conventional T1 and T2 images. AJNR Am J Neuroradiol 38:2073–2080

    CAS  PubMed  Google Scholar 

  154. Prieto R, Pascual JM, Rosdolsky M, Barrios L (2017) Preoperative assessment of craniopharyngioma adherence: magnetic resonance imaging findings correlated with the severity of tumor attachment to the hypothalamus. World neurosurgery

  155. Puget S, Garnett M, Wray A, Grill J, Habrand JL, Bodaert N, Zerah M, Bezerra M, Renier D, Pierre-Kahn A, Sainte-Rose C (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106:3–12

    PubMed  Google Scholar 

  156. Qi S, Lu Y, Pan J, Zhang X, Long H, Fan J (2011) Anatomic relations of the arachnoidea around the pituitary stalk: relevance for surgical removal of craniopharyngiomas. Acta Neurochir 153:785–796

    PubMed  Google Scholar 

  157. Raimondi AJ, Rougerie J (1994) A critical review of personal experiences with craniopharyngioma: clinical history, surgical technique and operative results. 1983. Pediatr Neurosurg 21:134–150 discussion 151-134

    CAS  PubMed  Google Scholar 

  158. Regine WF, Mohiuddin M, Kramer S (1993) Long-term results of pediatric and adult craniopharyngiomas treated with combined surgery and radiation. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 27:13–21

    CAS  Google Scholar 

  159. Repka MX, Miller NR, Miller M (1989) Visual outcome after surgical removal of craniopharyngiomas. Ophthalmology 96:195–199

    CAS  PubMed  Google Scholar 

  160. Samii M, Tatagiba M (1997) Surgical management of craniopharyngiomas: a review. Neurol Med Chir 37:141–149

    CAS  Google Scholar 

  161. Schmalisch K, Beschorner R, Psaras T, Honegger J (2010) Postoperative intracranial seeding of craniopharyngiomas--report of three cases and review of the literature. Acta Neurochir 152:313–319 discussion 319

    PubMed  Google Scholar 

  162. Schoenfeld A, Pekmezci M, Barnes MJ, Tihan T, Gupta N, Lamborn KR, Banerjee A, Mueller S, Chang S, Berger MS, Haas-Kogan D (2012) The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neuro-Oncol 108:133–139

    Google Scholar 

  163. Schulz-Ertner D, Frank C, Herfarth KK, Rhein B, Wannenmacher M, Debus J (2002) Fractionated stereotactic radiotherapy for craniopharyngiomas. Int J Radiat Oncol Biol Phys 54:1114–1120

    PubMed  Google Scholar 

  164. Schwartz TH (2015) Editorial: Does chiasmatic blood supply dictate endonasal corridors? J Neurosurg 122:1163–1164

    PubMed  Google Scholar 

  165. Schwartz TH, Morgenstern PF, Anand VK (2019) Lessons learned in the evolution of endoscopic skull base surgery. J Neurosurg 130:337–346

    PubMed  Google Scholar 

  166. Sherlock M, Reulen RC, Alonso AA, Ayuk J, Clayton RN, Sheppard MC, Hawkins MM, Bates AS, Stewart PM (2009) ACTH deficiency, higher doses of hydrocortisone replacement, and radiotherapy are independent predictors of mortality in patients with acromegaly. J Clin Endocrinol Metab 94:4216–4223

    CAS  PubMed  Google Scholar 

  167. Shi XE, Wu B, Fan T, Zhou ZQ, Zhang YL (2008) Craniopharyngioma: surgical experience of 309 cases in China. Clin Neurol Neurosurg 110:151–159

    PubMed  Google Scholar 

  168. Steno J, Malacek M, Bizik I (2004) Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings. Neurosurgery 54:1051–1058 discussion 1058-1060

    PubMed  Google Scholar 

  169. Steno J, Bizik I, Steno A, Matejcik V (2014) Recurrent craniopharyngiomas in children and adults: long-term recurrence rate and management. Acta Neurochir 156:113–122 discussion 122

    PubMed  Google Scholar 

  170. Sughrue ME, Yang I, Kane AJ, Fang S, Clark AJ, Aranda D, Barani IJ, Parsa AT (2011) Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma. J Neuro-Oncol 101:463–476

    Google Scholar 

  171. Thorp BD, Sreenath SB, Ebert CS, Zanation AM (2014) Endoscopic skull base reconstruction: a review and clinical case series of 152 vascularized flaps used for surgical skull base defects in the setting of intraoperative cerebrospinal fluid leak. Neurosurg Focus 37:E4

    PubMed  Google Scholar 

  172. Tomlinson JW, Holden N, Hills RK, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM (2001) Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group Lancet 357:425–431

    CAS  Google Scholar 

  173. Turel MK, Tsermoulas G, Gonen L, Klironomos G, Almeida JP, Zadeh G, Gentili F (2016) Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up. Neurosurg Focus 41:E11

    PubMed  Google Scholar 

  174. Ulfarsson E, Lindquist C, Roberts M, Rahn T, Lindquist M, Thoren M, Lippitz B (2002) Gamma knife radiosurgery for craniopharyngiomas: long-term results in the first Swedish patients. J Neurosurg 97:613–622

    PubMed  Google Scholar 

  175. Van Effenterre R, Boch AL (2002) Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg 97:3–11

    PubMed  Google Scholar 

  176. van Iersel L, Brokke KE, Adan RAH, Bulthuis LCM, van den Akker ELT, van Santen HM (2019) Pathophysiology and individualized treatment of hypothalamic obesity following craniopharyngioma and other suprasellar tumors: a systematic review. Endocr Rev 40:193–235

    PubMed  Google Scholar 

  177. Van Zele T, Bachert C (2011) Endoscopic skull base reconstruction after endoscopic endonasal approach. B-Ent 7(Suppl 17):41–46

    PubMed  Google Scholar 

  178. Wan MJ, Zapotocky M, Bouffet E, Bartels U, Kulkarni AV, Drake JM (2018) Long-term visual outcomes of craniopharyngioma in children. J Neuro-Oncol

  179. Wang KC, Hong SH, Kim SK, Cho BK (2005) Origin of craniopharyngiomas: implication on the growth pattern. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 21:628–634

    Google Scholar 

  180. Wang F, Jiang J, Zhang J, Wang Q (2017) Predicting pituitary stalk position by in vivo visualization of the hypothalamo-hypophyseal tract in craniopharyngioma using diffusion tensor imaging tractography. Neurosurg Rev

  181. Wang EW, Zanation AM, Gardner PA, Schwartz TH, Eloy JA, Adappa ND, Bettag M, Bleier BS, Cappabianca P, Carrau RL, Casiano RR, Cavallo LM, Ebert CS Jr, El-Sayed IH, Evans JJ, Fernandez-Miranda JC, Folbe AJ, Froelich S, Gentili F, Harvey RJ, Hwang PH, Jane JA Jr, Kelly DF, Kennedy D, Knosp E, Lal D, Lee JYK, Liu JK, Lund VJ, Palmer JN, Prevedello DM, Schlosser RJ, Sindwani R, Solares CA, Tabaee A, Teo C, Thirumala PD, Thorp BD, de Arnaldo Silva Vellutini E, Witterick I, Woodworth BA, Wormald PJ, Snyderman CH (2019) ICAR: endoscopic skull-base surgery. International forum of allergy & rhinology 9:S145–S365

    Google Scholar 

  182. Wannemuehler TJ, Rubel KE, Hendricks BK, Ting JY, Payner TD, Shah MV, Cohen-Gadol AA (2016) Outcomes in transcranial microsurgery versus extended endoscopic endonasal approach for primary resection of adult craniopharyngiomas. Neurosurg Focus 41:E6

    PubMed  Google Scholar 

  183. Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D, Shiminski-Maher T, Flamm ES, Epstein FJ, Miller DC (1994) Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 35:1001–1010 discussion 1010-1001

    CAS  PubMed  Google Scholar 

  184. Wijnen M, Olsson DS, van den Heuvel-Eibrink MM, Hammarstrand C, Janssen J, van der Lely AJ, Johannsson G, Neggers S (2018) Excess morbidity and mortality in patients with craniopharyngioma: a hospital-based retrospective cohort study. European journal of endocrinology / European Federation of Endocrine Societies 178:95–104

    Google Scholar 

  185. Wisoff JH (1994) Surgical management of recurrent craniopharyngiomas. Pediatr Neurosurg 21(Suppl 1):108–113

    PubMed  Google Scholar 

  186. Xiao G, Yuan X, Yuan J, Krumtally NA, Li Y, Feng C, Liu Q, Peng Z, Li X, Ding X (2014) Pituitary stalk management during the microsurgery of craniopharyngiomas. Experimental and therapeutic medicine 7:1055–1064

    PubMed  PubMed Central  Google Scholar 

  187. Yamada S, Fukuhara N, Oyama K, Takeshita A, Takeuchi Y, Ito J, Inoshita N (2010) Surgical outcome in 90 patients with craniopharyngioma: an evaluation of transsphenoidal surgery. World neurosurgery 74:320–330

    PubMed  Google Scholar 

  188. Yang I, Sughrue ME, Rutkowski MJ, Kaur R, Ivan ME, Aranda D, Barani IJ, Parsa AT (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28:E5

    PubMed  Google Scholar 

  189. Yano S, Hide T, Shinojima N (2017) Surgical outcomes of endoscopic endonasal skull base surgery of craniopharyngiomas evaluated according to the degree of hypothalamic extension. World neurosurgery 100:288–296

    PubMed  Google Scholar 

  190. Yasargil MG (1996) Microneurosurgery. Thieme, New York

    Google Scholar 

  191. Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P (1990) Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73:3–11

    CAS  PubMed  Google Scholar 

  192. Yu T, Sun X, Ren X, Cui X, Wang J, Lin S (2014) Intraventricular craniopharyngiomas: surgical management and outcome analyses in 24 cases. World neurosurgery 82:1209–1215

    PubMed  Google Scholar 

  193. Yue Q, Yu Y, Shi Z, Wang Y, Zhu W, Du Z, Yao Z, Chen L, Mao Y (2017) Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features. J Neurosurg:1–8

  194. Yuen KCJ, Mattsson AF, Burman P, Erfurth EM, Camacho-Hubner C, Fox JL, Verhelst J, Geffner ME, Abs R (2018) Relative risks of contributing factors to morbidity and mortality in adults with craniopharyngioma on growth hormone replacement. J Clin Endocrinol Metab 103:768–777

    PubMed  Google Scholar 

  195. Zacharia BE, Bruce SS, Goldstein H, Malone HR, Neugut AI, Bruce JN (2012) Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro-oncology 14:1070–1078

    PubMed  PubMed Central  Google Scholar 

  196. Zanation AM, Snyderman CH, Carrau RL, Kassam AB, Gardner PA, Prevedello DM (2009) Minimally invasive endoscopic pericranial flap: a new method for endonasal skull base reconstruction. Laryngoscope 119:13–18

    PubMed  Google Scholar 

  197. Zimmer LA, Theodosopoulos PV (2009) Anterior skull base surgery: open versus endoscopic. Current opinion in otolaryngology & head and neck surgery 17:75–78

    Google Scholar 

  198. Zoicas F, Schofl C (2012) Craniopharyngioma in adults. Front Endocrinol 3:46

    Google Scholar 

  199. Zoli M, Sambati L, Milanese L, Foschi M, Faustini-Fustini M, Marucci G, de Biase D, Tallini G, Cecere A, Mignani F, Sturiale C, Frank G, Pasquini E, Cortelli P, Mazzatenta D, Provini F (2016) Postoperative outcome of body core temperature rhythm and sleep-wake cycle in third ventricle craniopharyngiomas. Neurosurg Focus 41:E12

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland

    Giulia Cossu, Lorenzo Giammattei, Daniele Starnoni, Juan Barges-Coll, Roy Thomas Daniel & Mahmoud Messerer

  2. Department of Neurosurgery, Hopital Neurologique Pierre Wertheimer, Lyon, France

    Emmanuel Jouanneau & Moncef Berhouma

  3. Department of Neurosurgery, University Hospital of Naples Federico II, Napoli, NA, Italy

    Luigi M Cavallo & Paolo Cappabianca

  4. Department of Pediatric Neurosurgery, Arnold Palmer Hospital for Children, Orlando, FL, USA

    Samer K Elbabaa

  5. Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic

    Vladimir Benes

  6. Department of Neurological Surgery, University of Wisconsin Medical School and Public Health, Madison, USA

    Mustafa K. Baskaya

  7. Department of Neurosurgery, Erasme Hospital, Brussels, Belgium

    Michael Bruneau

  8. Department of Neurosurgery, University Hospital of Geneva, Geneva, Switzerland

    Torstein Meling & Karl Schaller

  9. Department of Neurological Science, Christian Medical College, Vellore, Tamilnadu, India

    Ari G Chacko

  10. Department of Neurosurgery and Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA

    A. Samy Youssef

  11. IRCCS Institute of neurological sciences of Bologna, Bellaria Hospital, Bologna, Italy

    Diego Mazzatenta

  12. Center for Biotechnology Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA

    Mario Ammirati

  13. Department of Neurosurgery, Hopital de la Timone, Marseille, France

    Henry Dufour

  14. Pituitary Neuroendocrine Center, Brigham and Women’s Hospital, Boston, MA, USA

    Edward LAWS

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  1. Giulia Cossu
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Contributions

We declare that Mahmoud Messerer had the idea for the article.

Giulia Cossu and Mahmoud Messerer performed the literature search. GC and MM together with Roy Thomas Daniel performed the literature analysis.

GC, MM and Moncef Berhouma drafted the article.

Emmanuel Jouanneau, Luigi M Cavallo, Samer K Elbabaa, Lorenzo Giammattei, Daniele Starnoni, Juan Barges-Coll, Paolo Cappabianca, Vladimir Benes, Mustafa K. Baskaya, Michael Bruneau, Torstein Meling, Karl Schaller, Ari G Chacko, A. Samy Youssef, Diego Mazzatenta, Mario Ammirati, Henry Dufour, Edward Laws, Moncef Berhouma, and Roy Thomas Daniel critically revised the article and gave a substantial contribution in the improvement of the content of the paper.

Corresponding author

Correspondence to Mahmoud Messerer.

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This article does not contain any studies with human participants performed by any of the authors.

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Comments

The authors are to be congratulated for composing this consensus statement on the present management of craniopharyngiomas in adult patients. The recommendations represent our current understanding of the surgical approaches and alternative treatment strategies for these tumors at first treatment and recurrence.

I personally am in agreement with the consensus recommendations as written. With the identification of targetable mutations in these tumors it will be important to modify recommendations for residual and recurrent tumors as evidence accrues as to the relative advantage of these treatments. As such recommendations may change rapidly.

A minor comment would reflect on the search terms used for the analysis- they have used “microscopic” and “endoscopic” but have not used the terms “transnasal” or “transsphenoidal”. The endoscope and microscope are visualization tools but not approaches in of themselves. With the terms used they have overlooked many papers that have long emphasized the importance of the transnasal approach as a good option for these tumors, before the use of the endoscope was popularized. This advantage of the transnasal approach is that it enables direct visualization of these tumors, along the axis of growth, without traversing the cerebrum in any fashion. Third ventricular extensions of sellar or suprasellar tumors are easily reached under direct visualization. In consideration of the microscopic transnasal approach, this now represents an over 40-year significant experience with the transnasal approach for accessible tumors (without significant lateral extent) that commenced with the microscope but was later facilitated with the endoscope, notably by Laws, Fahlbusch, and Weiss (1,2).

William Couldwell

Utah, USA

1. Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. (2004)Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 55(3):539–550.

2. Honegger J, Buchfelder M, Fahlbusch R, Däubler B, Dörr HG. (1992)Transsphenoidal microsurgery for craniopharyngioma. Surg Neurol. 37(3):189–196.

3. Laws ER Jr. (1980)Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg. 52(5):661-6

4. Weiss M.H. (1987) The transnasal transsphenoidal approach. In: Apuzzo MLJ (ed) Surgery of the third ventride. Williams & Wilkins, Baltimore, pp 476–494

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Cossu, G., Jouanneau, E., Cavallo, L.M. et al. Surgical management of craniopharyngiomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section. Acta Neurochir 162, 1159–1177 (2020). https://doi.org/10.1007/s00701-020-04265-1

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