Abstract
Craniopharyngiomas are benign but locally invasive tumors which are frequently located in the suprasellar region. Primary infundibular and infundibulo-tuberal craniopharyngiomas are rare because of their location and generally result in late diagnosis. Due to the unusual location, the chosen mode of treatment is very important for patient's recovery. With infundibular and infundibulo-tuberal lesions, two patients were referred to our clinic, one of them was not considered as craniopharyngioma as the primary diagnosis. Both masses were operated, removed totally and craniopharyngioma diagnosis was proven pathologically.
Highlights
Craniopharyngiomas are rare, benign but locally invasive tumors which arise from squamous epithelial remnants of Rathke’s pouch and can extend anywhere from nasopharynx to hypothalamus [1]
We present a primary infundibular cystic and a infundibulo-tuberal craniopharyngioma cases which are surgically well demonstrated for their infundibular and tuberal origin by endoscopic endonasal transsphenoidal approach
With the involment of hypothalamus, upper neurohypophysis and infundibulum, the infundibulo-tuberal syndrome may occur which is characterized by the hypogonadism, obesity, diabetes insipidus and somnolence which can seen at infundibulo-tuberal lesions [7,11]
Summary
Craniopharyngiomas are rare, benign but locally invasive tumors which arise from squamous epithelial remnants of Rathke’s pouch and can extend anywhere from nasopharynx to hypothalamus [1]. Magnetic resonance imaging (MRI) of the brain showed a mass lesion which was originating from infundibulum, had cystic components, measuring approximately 31 mm and extending to frontal lobe, suprasellar region and optic chiasm. She did not develop any new neurological symptoms following surgery and was discharged home on postoperative day 7 In this case, the origin of craniopharyngioma from the outer layer of infundibulum, from pars tuberalis, is detected by endoscopically, with extended approach the tumor was resected gross totally with its cyst component from infundibulum. The enlarged infundibulum was incised and the contents of the tumor were evacuated, the infundibulum was dissected from the superior and inferior parts for total resection via extended endoscopic approach with image guided neuronavigation system She had a lumbar drain placed intraoperatively and removed by post-operative day 5. Preoperative and postoperative contrast enhanced T1-weighted MR images are shown (Figure 2)
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