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Craniopharyngiomas are benign brain tumours and can affect children and adults.

Learn about the treatment options for Craniopharyngiomas at the UPMC Pituitary Center of Excellence.

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What is Craniopharyngioma?

Craniopharyngiomas are benign (non-cancerous) tumors that grow at the base of the brain near the pituitary gland.

Who is at risk for craniopharyngioma?

These tumors are most common in children between ages 5 and 10. In fact, almost half of all craniopharyngiomas develop in people younger than age of 20.

Types of craniopharyngioma

There are two key types of craniopharyngiomas:

  • Adamantinomatous (ordinary) craniopharyngioma is more common and occurs in children.
  • Papillary craniopharyngioma occurs in adults. These tumors occur less frequently. The exact cause of craniopharyngioma is not known. Though benign, craniopharyngioma tumors can place excessive pressure on the brain and cause severe headaches, vision problems, and vomiting. Damage to the pituitary gland can lead to hormonal problems, ranging from excessive thirst to stunted growth.

At UPMC, the preferred surgical treatment for craniopharyngiomas of the skull base is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

  • No incisions to heal
  • No disfigurement
  • Faster recovery time

EEA has proven safe and effective in children. More than 100 children have been treated by UPMC skull base surgeons using EEA — more than at any other neurosurgery center in the world.

Craniopharyngioma Symptoms and Diagnosis

Diagnosing craniopharyngioma

To make the diagnosis of craniopharyngioma, your doctor may:

  • Ask you about your symptoms and medical history.
  • Perform a physical exam.
  • Order diagnostic tests, such as MRI and CT scans.

Symptoms of craniopharyngiomas

Craniopharyngioma symptoms include:

  • Headache due to increasing pressure on the brain
  • Nausea and vomiting
  • Balance problems
  • Vision problems due to the tumor pressing on or damaging the optic nerve
  • Disruption of hormone production by the pituitary gland

Craniopharyngioma complications

Other conditions may result from damage to the pituitary gland done by the craniopharyngioma, including:

  • Hypothyroidism (weight gain, fatigue, cold intolerance, and constipation)
  • Adrenal failure (dizziness, hypoglycemia, cardiac arrhythmias, lethargy, confusion, anorexia, nausea, and vomiting)
  • Diabetes insipidus (excessive thirst and urination)
  • Decreased sexual drive, including impotence in men and amenorrhea in women
  • Delayed puberty and stunted growth in pediatric patients
  • Overeating, obesity, and sleepiness

Imaging and radiology tests for diagnosing craniopharyngiomas

The doctor may also recommend:

  • A neurologic exam to evaluate vision, hearing, balance, coordination, and reflexes.
  • MRI or CT scans to show the size and extent of the craniopharyngioma.

Depending on your other symptoms, such as hormone and visual problems, your doctor may refer you to an endocrinologist or an ophthalmologist to further diagnose your craniopharyngioma.

Craniopharyngioma Treatments

Minimally invasive surgery

Surgery is the primary treatment for craniopharyngiomas.

Craniopharyngiomas of the skull base may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the craniopharyngioma through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time. If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.

Although the goal of the surgery is total tumor removal with pituitary function preservation, in some cases the craniopharyngioma's proximity to critical brain structures (the hypothalamus, optic chiasm, and blood vessels) makes complete removal impossible.

The Expanded Endonasal Approach gives surgeons the best view of the undersurface of the optic nerves, chiasm, and pituitary stalk, assisting them in deciding whether to leave residual tumor attached to these important structures.

In cases where the tumor has clearly invaded the pituitary gland, surgeons may also remove the pituitary gland.

Gamma Knife® radiosurgery

Gamma Knife radiosurgery is a painless treatment procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.

Surgeons may use Gamma Knife radiosurgery:

  • After surgery to treat residual craniopharyngioma tumors.
  • At the time of tumor recurrence.

Doctors at UPMC — the nation's leading provider of Gamma Knife procedures — have used this technology to effectively treat 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

Radiation therapy

In instances where it's not safe to remove a craniopharyngioma tumor completely, radiation may follow surgery as the next preferred treatment.

Radiation therapy for residual craniopharyngioma tumors:

  • Eradicates the remaining tumor cells.
  • Has success rates on par with those of complete tumor removal.

Intracavitary irradiation with phosphorus-32

Intracavitary P-32 is used for primarily cystic tumors.

Meet Haley

Haley Spitznagel – Craniopharyngioma patient story 

Doctors first thought Haley Spitznagel was suffering from migraine headaches, but it turned out to be something much more serious.

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Meet Elizabeth

After two previous brain surgeries, this woman found UPMC's expert team—and long-awaited relief from an aggressive tumor growing at the base of her skull near the pituitary gland.

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Meet Sharon

Faced with the loss of her vision, this librarian found new hope with the EEA surgeons at UPMC, who gave her back the gift of sight.

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