RESUMO
BACKGROUND: Craniopharyngioma has historically been recognized to be a formidable pathology primarily due to its proximity to critical neurovascular structures and the challenging surgical corridors that surgeons have tried to reach this lesion. FOCUS OF REVIEW: In this work, we review the medical and surgical management of these tumors with a focus on clinical presentation, diagnostic identification, surgical approach, and associated adjuvant therapies. We will also discuss our current treatment paradigm using endoscopic, open, and combined approaches to craniopharyngiomas. The management of craniopharyngiomas requires a multidisciplinary team of surgeons, endocrinologists, and neuroanesthesiologists as well as neurocritical care specialists to deliver the most comprehensive and safest surgical resection with minimal postoperative morbidity.
Assuntos
Craniofaringioma/cirurgia , Neuroendoscopia/métodos , Neoplasias Hipofisárias/cirurgia , Adolescente , Criança , Pré-Escolar , Craniofaringioma/diagnóstico por imagem , Craniofaringioma/patologia , Craniofaringioma/fisiopatologia , Hemianopsia/fisiopatologia , Humanos , Hipopituitarismo/fisiopatologia , Imageamento por Ressonância Magnética , Procedimentos Neurocirúrgicos/métodos , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/fisiopatologia , Complicações Pós-Operatórias/epidemiologia , Radioterapia Adjuvante , Tomografia Computadorizada por Raios X , Transtornos da Visão/fisiopatologiaRESUMO
BACKGROUND: Pediatric pituitary adenomas are a rare medical entity that makes up a small portion of intracranial tumors in children and adolescents. Although benign, the majority of these lesions are secreting functional tumors with the potential for physiological sequela that can profoundly affect a child's development. FOCUS OF REVIEW: In this review, we discuss the medical and surgical management of these tumors with a focus on clinical presentation, diagnostic identification, surgical approach, and associated adjuvant therapies. We will also discuss our current treatment paradigm using endoscopic, open, and combined approaches to treat these tumors. The management of pituitary tumors requires a multidisciplinary team of surgeons, endocrinologists, and neuroanesthesiologists as well as neurocritical care specialists to deliver comprehensive care.