Clinico-epidemiological Profile of Craniopharyngiomas

Abstract

Background: Craniopharyngiomas are rare benign but locally infiltrative tumors of the supra-sellar region. Surgical removal and radiotherapy are modalities of treatment with good overall survival.
Objectives: Determine the demographic profile of Craniopharyngiomas in Kashmir as seen at Sher-i-Kashmir Institute of Medical Sciences Srinagar; Assess the clinical and radiological findings of such patients; Study various modes of management, their outcome and complications.
Study Design: Retrospective and Prospective Observational Study
Participants: Patients diagnosed with and treated for craniopharyngioma in the department of Neurosurgery SKIMS from January 2014 to July 2019.
Methods: 23 patients with a diagnosis of craniopharyngioma were studied for the demographic profile, clinical presentation, radiological morphology, histology, various modes of management and their complications.
Results: A bimodal age distribution with equal gender distribution was seen. The most common symptoms were headache (61%) followed by diminution of vision (48%) and nausea/vomiting (39%) . Most common location was supra-sellar (87%). All but one underwent surgery as the primary treatment. Majority of the patients (73%) were operated through a craniotomy approach with gross-total resection done in only 9 patients. The most common post-operative complication was diabetes insipidus.1 patient died in the post-operative period. Histology varied between children and adults. Radiotherapy was given to patients who underwent subtotal resection.
Conclusion: Craniopharyngioma is a slow-growing benign but locally infiltrative tumour. Symptoms of increased ICP, vision abnormalities and endocrine disturbances are common presentations. CT and MRI are radiological investigations of choice. Surgery is the mainstay of treatment. Radiotherapy can be used to select patients.
Implications: SKIMS has been routinely catering to patients of craniopharyngioma. This study can further guide the management of such patients and can act as a stepping stone for further research on this topic.