Craniopharyngiomas are benign tumors that occur at the base of the brain, above the pituitary gland. The term comes from:
Craniopharyngiomas nearly always involve the pituitary stalk, the connection between the pituitary gland and the brain.
The UCLA Pituitary Tumor Program offers comprehensive management of carniopharyngiomas. Our physicians have years of experience in diagnosing, treating and managing pituitary conditions. Our sophisticated diagnostic equipment, team approach and minimally invasive surgical procedures mark our program as one of the best in the country.
Craniopharyngiomas occur in both children and adults. Most children are diagnosed between five and 10 years of age. Craniopharyngiomas are relatively rare.
Craniopharyngiomas can grow to large sizes, even bigger than a golf ball, and may not cause any symptoms in the beginning.
There are two types of craniopharyngiomas:
Symptoms produced by a craniopharyngioma vary depending upon the tumor's location and the age of the patient. The symptoms also depend on which specific hormone is involved. Learn more about normal pituitary function.
Other symptoms include:
If the tumor involves the optic tracts, chiasm, or nerves, blindness can occur.
If the hypothalamus, an area at the base of the brain, is affected, symptoms may include:
Your doctor will conduct a physical examination and ask you about your symptoms and medical history. Diagnostic procedures include:
Your doctor may order a high-resolution magnetic resonance imaging (MRI) scan. This test is valuable because it allows the neuroradiologist to view the tumor from different angles.
In some cases, a powerful 3T (Tesla) MRI scanner can help define the location of critical brain structures affected by the tumor.
A computed tomography (CT) scan is also a good diagnostic tool as it detects calcification in the tumor
Pituitary hormone function testing is necessary for every patient with a craniopharyngioma. An endocrinologist who specializes in pituitary tumors will help evaluate the results.
Typically, a medical team, combining specialists from many disciplines, will manage your treatment. The UCLA Pituitary Tumor Program has experts in each of the specialties, working closely together to provide you with the most comprehensive, state-of-the-art surgical and non-surgical treatments.
Treatment options include:
If you are diagnosed with craniopharyngioma, you may require surgery to:
There are several surgical approaches to craniopharyngioma tumors. Your medical team will decide which approach to use based on:
The goal of surgery also differs for children and adults:
In adults, doctors often use a more conservative approach, aiming to establish a diagnosis and decompress the optic nerves, but not necessary attempt full removal of the tumor. Because the tumor almost always involves the pituitary stalk, attempting to remove the entire tumor often results in complete pituitary insufficiency.
The two basic approaches are:
The endoscopic endonasal approach is a minimally invasive approach, using your natural nasal passageway. It does not require a head incision. Our neurosurgeons have the advanced training and extensive experience necessary for performing this complex procedure.
An endoscopic technique can be very effective in safely removing tumor, while at the same time minimizing hospitalization time and discomfort.
However, not every craniopharyngioma tumor can be removed using an endonasal endoscopic approach. If you wish to find out whether you are a candidate for an endoscopic approach, please arrange a film review at email@example.com.
During an open craniotomy, your surgeon:
Your surgeon may be able to use a minimally invasive eyebrow incision keyhole approach.
Possible consequences and complication of surgery
Your doctor may recommend radiation therapy following surgery. Stereotactic radiosurgery is a technique that uses a highly focused dose of radiation delivered directly to the tumor. Because the radiation beam is sculpted to target only the tumor, the surrounding brain structures receive only a fraction of the radiation dose and may remain unharmed.
At the UCLA Pituitary Tumor Program, we use the advanced Novalis® Radiosurgery delivery system, which allows us to treat irregularly shaped tumors that are close to critical brain structures.
One drawback of radiation treatment is that it leads to delayed pituitary failure. This typically occurs several years after treatment, necessitating complete hormone replacement.
Pituitary hormonal dysfunction is common after craniopharyngioma surgery and/or radiation therapy. Problems with hypothalamic function can be particularly challenging to treat. You will require careful monitoring and follow-up visits with an endocrinologist.
To schedule an appointment with one of our physicians at the Pituitary Tumor Program, please call (310) 825 5111.