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1.
Childs Nerv Syst ; 35(11): 2133-2145, 2019 11.
Article in English | MEDLINE | ID: mdl-31385085

ABSTRACT

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.


Subject(s)
Craniopharyngioma/surgery , Neuroendoscopy/methods , Pituitary Neoplasms/surgery , Adolescent , Child , Child, Preschool , Craniopharyngioma/diagnostic imaging , Craniopharyngioma/pathology , Craniopharyngioma/physiopathology , Hemianopsia/physiopathology , Humans , Hypopituitarism/physiopathology , Magnetic Resonance Imaging , Neurosurgical Procedures/methods , Pituitary Neoplasms/diagnostic imaging , Pituitary Neoplasms/pathology , Pituitary Neoplasms/physiopathology , Postoperative Complications/epidemiology , Radiotherapy, Adjuvant , Tomography, X-Ray Computed , Vision Disorders/physiopathology
2.
Childs Nerv Syst ; 35(11): 2107-2118, 2019 11.
Article in English | MEDLINE | ID: mdl-31302729

ABSTRACT

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.


Subject(s)
ACTH-Secreting Pituitary Adenoma/surgery , Growth Hormone-Secreting Pituitary Adenoma/surgery , Microsurgery/methods , Neuroendoscopy/methods , Pituitary Neoplasms/therapy , Prolactinoma/therapy , ACTH-Secreting Pituitary Adenoma/diagnostic imaging , ACTH-Secreting Pituitary Adenoma/metabolism , ACTH-Secreting Pituitary Adenoma/physiopathology , Adenoma/diagnostic imaging , Adenoma/metabolism , Adenoma/physiopathology , Adenoma/surgery , Adolescent , Child , Child, Preschool , Craniotomy , Dopamine Agonists/therapeutic use , Growth Hormone-Secreting Pituitary Adenoma/diagnostic imaging , Growth Hormone-Secreting Pituitary Adenoma/metabolism , Growth Hormone-Secreting Pituitary Adenoma/physiopathology , Humans , Nasal Cavity , Natural Orifice Endoscopic Surgery/methods , Pituitary Neoplasms/diagnostic imaging , Pituitary Neoplasms/metabolism , Pituitary Neoplasms/physiopathology , Prolactinoma/diagnostic imaging , Prolactinoma/physiopathology , Sphenoid Bone
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