Abstract
Purpose
Craniopharyngiomas are 5–10 % of all pediatric tumors, but are seldomly encountered in the perinatal period. Only seven instances of a truly antenatal diagnosis of a congenital craniopharyngioma that subsequently underwent radical surgery have been reported. We present the case of a patient who received the diagnosis of a suprasellar tumor during the prenatal period and received radical surgery.
Methods
We report a case of a neonatal craniopharyngioma treated surgically.
Results
The pregnancy progressed uneventfully until a routine ultrasound at 37 weeks of gestation showed a 15 × 15 mm high echoic mass in the center of the fetal head. Neonatal Gd-enhanced T1-weighted MRI at 5 days of life showed a homogenously enhanced mass (16×22×15 mm) in the sellar and suprasellar lesion. As the tumor showed rapid growth at the 3rd month of life, the patient underwent a surgical treatment and the mass was totally removed. Three years later, the physical and mental development of the patient was normal, and Gd-MRI studies showed no tumor recurrence.
Conclusion
The present case is the eighth case of a truly antenatal diagnosis of a craniopharyngioma that underwent successful radical surgery. Craniopharyngioma is a benign tumor and thought to be a slow growing tumor in childhood. The results of radical surgery were very poor, and the mortality and morbidity rates were high in the previous reports due to the huge size of tumor at operation. The present case demonstrated the rapid growth in short interval of Gd-MRI. This is the first report of tumor kinetics of congenital craniopharyngioma with previous reports. The calculated tumor doubling time in our case was 37 days.
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References
Severino M, Schwartz ES, Thurnher MM, Rydland J, Nikas I, Rossi A (2010) Congenital tumors of the central nervous system. Neuroradiology 52:531–548
Isaacs H Jr (2002) II. Perinatal brain tumors: a review of 250 cases. Pediatr Neurol 27(5):333–342
Isaacs H Jr (2009) Fetal brain tumors: a review of 154 cases. Am J Perinatol 26(6):453–466
Iyer CGS (1952) Case report of an adamantinoma present at birth. J Neurosurg 9:221–228
Ohmori K, Collins J, Fukushima T (2007) Craniopharyngiomas in children. Pediatr Neurosurg 43(4):265–278
Arai T, Ohno K, Takada Y, Aoyagi M, Hirakawa K (2003) Neonatal craniopharyngioma and inference of tumor inception time: case report and review of the literature. Surg Neurol 60(3):254–259
do Prado Aguiar U, JL VA, JC EV, Hikaro Toita M, de Aguiar G B (2013) Congenital giant craniopharyngioma. Childs Nerv Syst 29:153–157
Jurkiewicz E, Bekiesińska-Figatowska M, Duczkowski M, Grajkowska W, Roszkowski M, Czech-Kowalska J, Dobrzańska A (2010) Antenatal diagnosis of the congenital craniopharyngioma. Pol J Radiol 75(1):98–102
Kültürsay N, Gabel F, Mutluer S, Șenreçper S, Öziz E, Oral R (1995) Antenatally diagnosed neonatal craniopharyngioma. J Perinatol 15(5):426–428
Lonjon M, Dran G, Casagrande F, Vandenbos F, Mas JC, Richelme C (2005) Prenatal diagnosis of a craniopharyngioma: a new case with radical surgery and review. Childs Nerv Syst 21(3):177–180
Müller-Scholden J, Lehrnbecher T, Müller HL, Bensch J, Hengen RH, Sőrensen N, Stockhausen HB (2000) Radical surgery in a neonate with craniopharyngioma. Pediatr Neurosurg 33(5):265–269
Wellons III JC, Tubbs RS (2006) Staged surgical treatment of a giant neonatal craniopharyngioma. J Neurosurg 105 (1 Suppl Pediatrics):76
Haney SM, Thompson PM, Cloughesy TF, Alger JR, Toga AW (2001) Tracking tumor growth rates in patients with malignant gliomas: a test of two algorithms. AJNR Am J Neuroradiol 22:73–82
Anegawa S, Hayashi T, Nakagawa S, Furukawa Y, Tomokiyo M (2001) Craniopharyngioma with rapid regrowth—role of MIB-1 labeling index [in Japanese]. No Shinkei Geka 29:727–733
Duo D, Gasverde S, Benech F, Zenga F, Giordana MT (2003) MIB-1 immunoreactivity in craniopharyngiomas: a clinicopathological analysis. Clin Neuropathol 22:229–234
Kim SK, Wang KC, Shin SH, Choe G, Chi JG, Cho BK (2001) Radical excision of pediatric craniopharyngioma: recurrence pattern and prognostic factors. Child Nerv Syst 17:531–536
Losa M, Vimercati A, Acerno S, Barzaghi RL, Mortini P, Mangili F, Terreni MR, Santambrogio G, Giovanelli M (2004) Correlation between clinical characteristics and proliferative activity in patients with craniopharyngioma. J Neurol Neurosurg Psychiatry 75:889–892
Reghaven R, Dickey RT Jr, Margraf LR, White CL III, Coimbra C, Hynan LS, Rushing EJ (2000) Proliferative activity in craniopharyngiomas: clinicopathological correlations in adults and children. Surg Neurol 54:241–248
Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S, Angius D, Weber G, Chiumello G, Giovanelli M (2011) Neurosurgical treatment of craniopharyngioma in adults and children: long-term results in a large case series. J Neurosurg 114:1350–1359
Puget S, Garnett M, Wray A, Grill J, Habrand JL, Bodaert N, Zerah M, Bezerra M, Renier D, Pierre-Kahn A, Sainte-Rose C (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106(1 Suppl Pediatrics):3–12
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Kageji, T., Miyamoto, T., Kotani, Y. et al. Congenital craniopharyngioma treated by radical surgery: case report and review of the literature. Childs Nerv Syst 33, 357–362 (2017). https://doi.org/10.1007/s00381-016-3249-1
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DOI: https://doi.org/10.1007/s00381-016-3249-1