Objective: In this study, the author retrospectively reviewed all the cases (18 patients) of
craniopharyngiomas (CRFs) treated at KKUH in the last decade (January 2000-December
2010), looking for factors that affect the outcome of these challenging tumors.
Results: There were 18 patients, 11 females (61%) and 7 males (39%), with a median age of
24 years. The main presenting symptoms were reduced vision in 66.7%, symptoms of raised
intracranial pressure (ICP) in 50%, endocrinal problems in 33.3%, seizures in 16.7%,
and hemiparesis in 5.6%. Radiologic studies showed 72% of tumors have mixed solid
and cystic components, calcification in 83%, and ventricular dilatation in 50% of
cases. The tumor extended to the posterior fossa in 11% and to both middle and posterior
fossae in 11% of cases. Tumor excision through pterional craniotomy was done in 89%
of patients and through a subfrontal approach in 11%. Gross total removal (GTR) was
achieved in 17% and subtotal resection (STR) in 83%. Tumor recurred in 9 patients
(50%), 4 of whom (44%) had postoperative radiotherapy. The outcome was good in 10
patients (56%), poor in 6 patients (33%), and 2 patients died (11%). The patients’
age, radiological appearance of tumors, and location of tumors were significantly
correlated with the outcome (P = 0.02, 0.02, 0.04, respectively).
Conclusion: CRF is a common tumor in children. Ophthalmologists and pediatricians should be aware
of the clinical presentation and refer patients early to specialized centers for treatment.
Total resection of the tumor should be the neurosurgeon’s goal as it offers the best
chance of cure.