Surgical Treatment of Craniopharyngioma: Transcranial Approach

  • Jun Pan
  • Jun-xiang Peng
  • Song-tao Qi


Craniopharyngiomas may develop at any point along the pituitary–hypothalamus axis, from the sella turcica to the infundibularis partes of the third ventricle but they most commonly expand in the suprasellar cistern or within the third ventricle floor [1–3]. Tumors originate from along the path of embryonic development of Rathke’s pouch out pia mater of the third ventricle. Tumors are usually classified according to the involving anatomical sites; however, large tumors may severely compress, distort, or involve neural tissue (third ventricular floor, pituitary stalk, and optic tract structures), making preoperative evaluation difficult even with excellent-quality neuroradiological studies [3–7]. In such a small area of the sellar region, therefore, accurate typing is sometimes difficult when the tumor is large. Here we propose a clinical classification system (QST classification system) based on both the tumor’s original site and the relationship of the tumor to the suprasellar membranous structures (namely the diaphragma, the arachnoid membrane, and the pia mater) [1, 6–8].


  1. 1.
    Pan J, Qi S, Liu Y, Lu Y, Peng J, Zhang X, et al. Growth patterns of craniopharyngiomas: clinical analysis of 226 patients. J Neurosurg Pediatr. 2016;17(4):418–33.CrossRefPubMedGoogle Scholar
  2. 2.
    Van Effenterre R, Boch AL. Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg. 2002;97:3–11.CrossRefPubMedGoogle Scholar
  3. 3.
    Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P. Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg. 1990;73:3–11.CrossRefPubMedGoogle Scholar
  4. 4.
    Hoffman HJ. Surgical management of craniopharyngioma. Pediatr Neurosurg. 1994;21(Suppl 1):44–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg. 2008;108:715–28.CrossRefPubMedGoogle Scholar
  6. 6.
    Qi S, Lu Y, Pan J, Zhang X, Long H, Fan J. Anatomic relations of the arachnoidea around the pituitary stalk: relevance for surgical removal of craniopharyngiomas. Acta Neurochir. 2011;153:785–96.CrossRefPubMedGoogle Scholar
  7. 7.
    Qi S, Pan J, Lu Y, Gao F, Cao Y, Peng J, et al. The impact of the site of origin and rate of tumour growth on clinical outcome in children with craniopharyngiomas. Clin Endocrinol. 2012;76:103–10.CrossRefGoogle Scholar
  8. 8.
    Pascual JM, Carrasco R, Prieto R, Gonzalez-Llanos F, Alvarez F, Roda JM. Craniopharyngioma classification. J Neurosurg. 2008;109:1180–2; author reply 1182–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Jun Pan
    • 1
  • Jun-xiang Peng
    • 1
  • Song-tao Qi
    • 1
  1. 1.Department of NeurosurgeryNanfang Hospital of Southern Medical UniversityGuangzhouChina

Personalised recommendations