Primary Adult Infradiaphragmatic Craniopharyngiomas: Clinical Features, Management and Outcomes in One Chinese Institution

Objective: This study was designed to evaluate the clinical, radiologic, histologic, and surgical outcome characteristics of this disease treated in a single institution. Methods: Total 16 adult patients underwent transsphenoidal microsurgery from October 2005 to December 2010. The clinical, radiological, operative, and pathological findings of the patients were reviewed retrospectively. Results: Pituitary dysfunction was presented in 12 patients, visual acuity and/or field deterioration was found in 11 patients, and headache was complained in 8 patients. Hyperprolactinemia was presented in seven of nine female patients. All lesions were resected by transsphenoidal microsurgery as the primary procedure. A GTR was achieved in 3 of 16 patients; a radical subtotal resection was attained in the rest 13 patients. Nine cases were histologically classified as adamantinous subtype. After a mean follow-up of 50 months, two patients experienced recurrence. All female patients who had hyperprolactinemia experienced a gain of function postoperatively. Six patients experienced new diabetes insipidus. Visual field improved or normalized in eight of nine patients. Visual acuity improved in one case and worsened in one patient. Conclusion: Primary adult infradiaphagmic craniopharyngiomas are relatively rare lesions occurring in young adults. Transsphenoidal surgery, including tearing the cyst walls off the diaphragma sellae and protecting normal pituitary tissue as much as possible, is recommended.