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Acta Neurochirurgica

, Volume 153, Issue 4, pp 773–784 | Cite as

Intraventricular craniopharyngioma: morphological analysis and outcome evaluation of 17 cases

  • Jun Pan
  • Songtao Qi
  • Yuntao Lu
  • Jun Fan
  • Xi’an Zhang
  • Jie Zhou
  • Junxiang Peng
Clinical Article

Abstract

Purpose

There is still some confusion with regard to the tumor–third ventricle floor (3rd VF) relationship of craniopharyngiomas located exclusively within the third ventricle. This study aims to provide some evidence to clarify the growth pattern of intraventricular craniopharyngiomas (IVC), and to summarize the surgical strategy and outcome.

Methods

Seventeen cases of IVC were reviewed retrospectively in relation to preoperative imaging, clinical presentation, intraoperative findings, tumor pathology, and surgical outcome. The tumor–3rd VF relationship and the tumor's stratification were analyzed based on intraoperative inspection and histology.

Findings

Variable adherence patterns of IVC to the 3rd VF were found, which were classified as (a) purely IVC with pedicle attachment to 3rd VF (two cases), (b) intra-3rd VF tumors with wide-based attachment but a dissectible tumor boundary (seven cases), and (c) intra-3rd VF tumors with an undissectible wide, tight attachment (eight cases). Histological analysis revealed that both of the two cases with growth pattern “a” intruded into the third ventricular cavity without a covering layer of neural tissue (which only exists in the squamous-papillary subtype). Tumors with growth pattern “b” and “c,” in contrast, were noted to have a thin layer of neural tissue. This occurred in both subtypes (11 adamantinomatous, 4 papillary). Total removal was accomplished in all tumors demonstrating growth pattern “a” and “b.” There was also better preservation of the 3rd VF and consequently a better outcome. On the other hand, total removal was only achieved in 50% of tumors showing growth pattern “c” including one mortality. No recurrence has been encountered in patients whose tumors were totally removed.

Conclusion

Variable adherence patterns and tumor subtypes were observed in IVCs, which were correlated to the tumor pathology, resectability, and subsequent prognosis.

Keywords

Histology Intraventricular craniopharyngiomas Neurosurgery Third ventricle floor 

Notes

Acknowledgments

The editorial office would like to thank Dr. Apok for the editing and rewriting of the English language.

Conflicts of interest

This study is financially supported by the Chinese national natural science funding (No. 81072067) and the Guangdong province natural science funding (No. 9451051501003959), China

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Jun Pan
    • 1
  • Songtao Qi
    • 1
  • Yuntao Lu
    • 1
  • Jun Fan
    • 1
  • Xi’an Zhang
    • 1
  • Jie Zhou
    • 1
  • Junxiang Peng
    • 1
  1. 1.Department of Neurosurgery, Nanfang HospitalSouthern Medical UniversityGuangzhouChina

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