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Craniopharyngioma

Last reviewed: 9 Apr 2025
Last updated: 08 Sep 2021

Summary

Definition

History and exam

Key diagnostic factors

  • visual loss
  • macrocephaly and hydrocephalus
  • growth failure
Full details

Other diagnostic factors

  • symptoms of hypogonadotropic hypogonadism (amenorrhea, erectile dysfunction)
  • headache
  • symptoms of intracranial hypertension (nausea, vomiting, decreased sensorium, diplopia)
  • galactorrhea
  • optic atrophy
  • polyuria/polydipsia
Full details

Risk factors

  • age 5 to 14 years
  • age 50 to 70 years
Full details

Diagnostic tests

1st tests to order

  • ophthalmologic evaluation; computerized visual-field examination
  • MRI brain (contrast-enhanced)
  • CT brain (contrast-enhanced)
  • serum prolactin
  • serum growth hormone (GH)
  • serum insulin-like growth factor 1 (IGF-1)
  • serum insulin-like growth factor binding protein-3 (IGFBP-3)
  • provocative growth hormone (GH) tests
  • serum luteinizing hormone
  • serum follicle-stimulating hormone
  • morning serum testosterone
  • serum thyroid-stimulating hormone and T3/T4
  • morning serum cortisol and adrenocorticotropic hormone (ACTH)
  • serum electrolytes
  • urine and serum osmolality
  • urine specific gravity
  • plain x-rays for bone age
Full details

Tests to consider

  • tissue histology
Full details

Treatment algorithm

ACUTE

at initial treatment

ONGOING

post initial treatment

Contributors

Authors

Marc C. Chamberlain, MD
Marc C. Chamberlain

Chief

Division of Neuro-Oncology

Department of Neurology and Neurological Surgery

University of Washington

Seattle Cancer Care Alliance

Seattle

WA

Disclosures

MCC declares that he has no competing interests.

Acknowledgements

Dr Marc C. Chamberlain would like to gratefully acknowledge Dr Daniel L. Silbergeld, a previous contributor to this topic.

Disclosures

DLS declares that he has no competing interests.

Peer reviewers

Larry Junck, MD

Professor of Neurology

Department of Neurology

University of Michigan

Ann Arbor

MI

Disclosures

LJ declares that he has no competing interests.

Jeff Raizer, MD

Associate Professor of Neurology

Director of Medical Neuro-Oncology

Northwestern University

Chicago

IL

Disclosures

JR declares that he has no competing interests.

Ramez Kirollos, MBChB, FRCS(Ed), FRCS(Eng), MD, FRCS(SN)

Consultant Neurosurgeon

Addenbrooke's Hospital

Cambridge University Hospitals NHS Foundation Trust

Cambridge

UK

Disclosures

RK declares that he has no competing interests.

Keyoumars Ashkan, BA, BSc, MB BCh, MRCP, FRCS, FRCPS, FRCS(SN), MD

Consultant Neurosurgeon and Lead of Neuro-Oncology

King's College Hospital

London

UK

Disclosures

KA declares that he has no competing interests.

Edwin S. Kulubya Jr., MD, MBA

Neurosurgical Research Fellow

UC Davis Medical Center

Sacramento

CA

Disclosures

EK declares that he has no competing interests.

References

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Key articles

Garre ML, Cama A. Craniopharyngioma: modern concepts in pathogenesis and treatment. Curr Opin Pediatr. 2007 Aug;19(4):471-9. Abstract

Puget S, Garnett M, Wray A, et al. Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg. 2007 Jan;106(1 suppl):3-12. Abstract

Minniti G, Saran F, Traish D, et al. Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiother Oncol. 2007 Jan;82(1):90-5. Abstract

Dekkers OM, Biermasz NR, Smit JW, et al. Quality of life in treated adult craniopharyngioma patients. Eur J Endocrinol. 2006 Mar;154(3):483-9.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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