Craniopharyngioma Treatment
Expert Care for Pituitary Cancer Patients
The Department of Neurosurgery at Rutgers Health at RWJBarnabas Health treats brain and spinal tumors in pediatric patients, including craniopharyngioma. We provide comprehensive craniopharyngioma diagnosis, treatment, and management through a multi-disciplinary team approach utilizing the expertise of physicians in various fields to provide the best care. Your child’s doctors will include board-certified pediatric neurologists, neurosurgeons, and other support staff.
What Is a Craniopharyngioma?
Craniopharyngiomas are rare, slow-growing, benign (noncancerous) brain tumors found near the pituitary gland. These tumors are usually part solid mass, part fluid-filled cyst. They are so-named because “cranio” means “head,” “pharyng” means “throat,” and “oma” means “condition.” It is an extremely rare tumor, with only about 100 new cases diagnosed in children nationwide per year, which equates to about 2 to 3 occurrences per million children.
To better understand what a craniopharyngioma is and why it is harmful, it helps to understand the function of the pituitary gland, which is part of the endocrine system. The pituitary gland produces several hormones controlling important body functions. It most commonly occurs in children between the ages of 5 to 10, but sometimes occurs in older adults.
While these tumors are benign, they are not harmless. As the tumors grow, they press on the brain, which can cause hormonal changes, stunt growth, and much more. Without treatment, the consequences can be devastating, and even lead to death.
Craniopharyngioma Symptoms
Depending on the size and location of the tumor and age of the patient, symptoms vary.
Symptoms of craniopharyngioma may include:
- Changes in personality
- Headaches, which may occur if the tumor compresses the brain
- Vision changes, including partial vision loss or blindness
- Excessive sleepiness, general fatigue
- Low blood pressure
- Diabetes insipidus (includes symptoms of extreme thirst and urination, caused by the absence of the antidiuretic hormone)
- Confusion
- Unexplained nausea and vomiting
- Stunted growth and delayed puberty
- Seizures
- Speech difficulties
Craniopharyngioma Diagnosis
To diagnose a craniopharyngioma, your child’s doctor will ask you for a medical history, as well as perform a physical and neurological examination.
The following tests may be used to diagnose a craniopharyngioma:
- Physical exam and history: Your child’s physician will check for vital signs, look for any signs of disease, and look for anything unusual, such as lumps.
- Neurological exam: This checks brain, spinal cord, and nerve function. The tests include a series of questions which evaluate the patient’s mental status, ability to walk, coordination, and how well the reflexes, senses, and muscles work.
- Visual field exam: Loss of vision can be a sign that a tumor has damaged or is pressing on the part of the brain controlling eyesight. The test measures central vision and peripheral vision.
- Computerized tomography (CT) scan: This procedure takes images of inside the body from different angles.
- Magnetic resonance imaging (MRI) scan: This procedure is the gold standard for locating a brain tumor. It takes detailed images of the soft, internal structures of the body and can definitively locate a tumor and show its size and location.
- Blood tests: For this test, a blood sample is analyzed to measure amounts of certain substances which can be indicators of disease.
- Hormone levels tests: Because the pituitary gland secretes hormones, a craniopharyngioma tumor presses against it and affects hormone levels. This procedure takes a blood sample to look for unusual levels of hormones, including the thyroid-stimulating hormone (TSH) or adrenocorticotropic hormone, which are made by the pituitary gland.
- Biopsy: This is the only definitive way to determine tumor type. A sample of tissue is taken during a craniotomy surgery, in which a hollow needle is inserted through a hole in the skull/brain to access the area where the tumor is located. It is guided by computer to find the tumor and not damage any adjacent nerves of other structures. Once the sample is taken, a neuropathologist views the tissue under a microscope to check for tumor cells.
Risk Factors for Craniopharyngioma
There are no known risk factors for craniopharyngioma.
Craniopharyngioma Treatment
Unlike some other brain tumors, a childhood craniopharyngioma can be diagnosed and removed during the same surgery. There are different types of treatments for child craniopharyngioma patients.
- Surgery: To remove all or part of a child’s tumor, surgery is often recommended. The type of procedure done depends on the location and size of the patient’s tumor. An open surgery, called craniotomy, involves opening a portion of the skull to gain access to the tumor. Another type of craniopharyngioma surgery is called the transsphenoidal procedure, in which special surgical tools are inserted up the nose, passing through a natural corridor to the tumor, without damaging adjacent or nearby structures.
- Radiation therapy: Using high-energy X-rays, radiation therapy can help kill a tumor, even that tumor’s remnants that could not be removed through surgery.
- Chemotherapy: This treatment is used for cancerous tumors, but it can also successfully impede the growth of benign tumors such as craniopharyngioma.
- Biologic therapy: Also called immunotherapy, this helps the patient fight craniopharyngioma by using the patient’s own immune system.
Craniopharyngioma Prognosis
The median 10-year craniopharyngioma survival rate is about 80%. Long-term complications may occur, however, such as the need for hormone replacement, and any problems related to brain damage.
Request an appointment online now or call 833-656-3876.