Learning from cases: Analysis of two cases of craniopharyngioma from the 19 th to the 21 st centuries.

John R Apps,Juan-Pedro Martinez-Barbera,Thomas S Jacques,Alex Virasami,Owen Arthurs,Eduard Winter,J Ciaran Hutchinson,Susan Shelmerdine,Thomas Czech

doi:10.12688/f1000research.19626.1

Abstract

This manuscript describes the study of two cases of craniopharyngioma, which have been examined repeatedly over three separate centuries. This includes analysis by Josef Engel in 1839, who sought to uncover the physiological role of the pituitary gland; Jacob Erdheim in 1904, who initially described the disease we now call craniopharyngioma, and recent high resolution MRI and micro-CT imaging and attempted DNA analyses of the tumours. The cases highlight how, rightly or wrongly, our interpretation of data is shaped by the technologies, methodologies and prevailing theories of a given time.

Highlights

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Engel noted several morphological correspondences between the pituitary gland and the cerebellum: both are covered by a tent of dura mater with an opposite semi-circular opening to connect with other parts of the brain, both lie within a bony depression in the midline skull base, both are “kidney-shaped”, both are bordered by a venous ring, the pituitary is surrounded by the arterial circle of Willis, while branches of the vertebral arteries enclose the cerebellum
Virtual dissection of 1828 case of craniopharyngioma described by Josef Engel by micro-CT imaging

Summary

30 Aug 2019 report report

Dying in a state of severe emaciation, post mortem examination identified a large cystic lesion in the region of the pituitary which was subsequently retained for further studies This patients tumour was kept, and studied by Josef Engel, a pathologist completing his PhD thesis, “Über den Hirnanhang und den Trichter“ (On the pituitary and the infundibulum) in 1839, working under the guidance of Carl von Rokitansky, one of the fathers of modern scientific pathology. Almost 80 years, two emperors and one unification with Hungary later, the scientific report of this specimen emerged in the literature in 1904, as part of a large study of pituitary pathology by Jacob Erdheim In his 200 page paper, “Über Hypophysenganggeschwulste und Hirncholesteatome”, Erdheim defined a cohort of lesions he called “hypophyseal duct tumors”[4] (Erdheim 1904).

Data File Video 2

McLean SF

Erdheim J

12. Simmons JEe