Surgical management of craniopharyngiomas in the pediatric population.

BACKGROUND: Craniopharyngiomas (CPs) are benign, locally aggressive neoplasms that comprise approximately 10% of pediatric brain tumors. The role of surgical management for CPs is discussed in this review.
METHODS: A review of the goals and techniques associated with selected surgical approaches for the treatment of CPs in the pediatric population is provided.
RESULTS: CPs may be a cause of significant morbidity in children, requiring long-term, multimodal management by a team of specialists in order to optimize patient outcomes. Surgical intervention for CPs remains an important component of treatment, and depends upon establishing realistic and well-defined goals prior to any operation. Many transcranial and transsphenoidal approaches are available for approaching and resecting CPs. A summary of the rationale behind the timing and appropriateness of various surgical approaches, as well as associated benefits, pitfalls, and outcomes, is provided in this review.
CONCLUSION: Consistent longitudinal management by an interdisciplinary team can alter the treatment course in patients with CPs from a debilitating, morbid or lethal condition to a chronic, survivable disease with functional adult livelihood. Excellent outcomes in children with CPs are obtained only by close, frequent monitoring and by developing a keen sense of judgment regarding the appropriateness, timing and aggressiveness of any particular intervention. Copyright 2010 S. Karger AG, Basel.