Suprasellar tumors in children: a review of clinical manifestations and managements.

The records of 98 children with suprasellar tumors treated between 1950 and 1975, at Columbia-Presbyterian Medical Center, were reviewed. Most of the children with germ cell tumors or posterior chiasmal gliomas irradiated with 5000 rad in six weeks using extended field, children with craniopharyngiomas treated with total resection when the tumor was limited to the suprasellar area, and children with craniopharyngiomas treated with combined surgery and postoperative irradiation when the lesions could not be resected totally, have generally survived long with reasonably good quality of life. More passive dependent immature responses were noted in most children with anterior chiasmal gliomas due to persistent residual mass after irradiation, although they have survived long. An attention to details of the clinical picture, the age at presentation, the finding of diabetes insipidus, and the presence of calcification and intrasellar extension of the tumor, should help with the selection of the appropriate treatment technique and, thus, influence the probability of tumor control as well as of complications.