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Ji C, Cheng H, Zhou X, Cao X, Qiao N, Shi C, Zhang Y, Ye Z, Zhao Y. Ectopic recurrence craniopharyngioma: series report and literature review. Chin Neurosurg J 2023; 9:13. [PMID: 37147737 PMCID: PMC10163818 DOI: 10.1186/s41016-023-00326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Craniopharyngioma is a common intracranial tumor located in the sellar-suprasellar region. Due to the involvement of adjacent structures, it can lead to increased intracranial pressure, visual impairment, and endocrine deficiencies. Surgical resection is the primary treatment, but it is a tough challenge to achieve total resection, which will led to the frequency of recurrences and progressions. Among them, distant spread is extremely rare, but important complication, identifying and providing proper therapy, is crucial. METHODS We report two cases of ectopic recurrence craniopharyngioma and make a literature review for the published similar case reports. RESULTS Our literature review revealed 63 cases (including our patient). The onset age in children group and adult group ranges from 2-14 years old (6.70 ± 3.33) to 17-73 years old (40.63 ± 15.58), while the interval year between tumor initiation and ectopic recurrence ranges from 0.17-20 (7.28 ± 6.76) years to 0.3-34 (6.85 ± 7.29). Achieving gross total resection seems not to prevent the ectopic recurrence. The major pathology of ectopic recurrence craniopharyngioma is adamantinomatous type. The most common site of ectopic recurrence is frontal lobe. According to the pathogenesis, 35 cases were seeding along the surgical approach, and 28 cases were seeding via the CSF pathway. CONCLUSION Ectopic recurrence craniopharyngioma is rare, but it can lead to serious symptoms. Delicate surgical procedure can help to reduce the risk of ectopic recurrence, and standardized follow-up can provide valuable information for treatment.
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Affiliation(s)
- Chenxing Ji
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
| | - Haixia Cheng
- Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Xiang Zhou
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
| | - Xiaoyun Cao
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
| | - Nidan Qiao
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
| | - Chengzhang Shi
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
| | - Yichao Zhang
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
| | - Zhao Ye
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China.
| | - Yao Zhao
- Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
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Selfa A, Arráez C, Ros Á, Linares J, Cerro L, Arráez MÁ. Ectopic recurrence of craniopharyngioma in the posterior fossa: Case report and review of the literature. NEUROCIRUGIA (ENGLISH EDITION) 2023; 34:32-39. [PMID: 36623891 DOI: 10.1016/j.neucie.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/19/2022] [Indexed: 06/17/2023]
Abstract
Craniopharyngiomas are benign epithelial tumors which may very occasionally recur in ectopic locations. We present two cases of ectopic recurrence, both in the posterior fossa, and provide a review of the literature with basic statistics. Two patients admitted to our institution with posterior fossa lesions underwent gross total resection. Pathological studies showed adamantinomatous craniopharyngiomas (ACP). Both patients had a prior history of suprasellar tumor surgery. We also reviewed the related data and undertook a basic statistical analysis. We found 67 cases of ectopic recurrent craniopharyngioma (including the present cases): 51 cases were adamantinomatous (76%), 6 papillary (9%) and 10 unknown (15%). 18 cases occurred in the posterior fossa, all of them diagnosed as the ACP subtype. The intervals until recurrence were 15.15 years for posterior fossa recurrences and 5.75 years for supratentorial cases. Student t test showed significant differences in time to recurrence (p 0.002). Gross total resection was performed in 53 cases (79%), subtotal resection+radiotherapy in 3 (5%) and 11 (16%) cases were treated with other options. Ectopic recurrence is a rare but possible event. Those in the posterior fossa may appear later than in the supratentorial space. ACP is likely to be the most common subtype in these cases, possibly due to its more aggressive behavior compared to the papillary subtype. Long term follow-up should be performed to detect ectopic recurrences. Ectopic recurrences are often surgically accessible and gross total resection should be achieved.
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Affiliation(s)
- Antonio Selfa
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain.
| | - Cinta Arráez
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain
| | - Ángela Ros
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain
| | - Jorge Linares
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain
| | - Laura Cerro
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain
| | - Miguel Ángel Arráez
- Department of Neurological Surgery, Hospital Regional Universitario, Malaga, Spain
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Selfa A, Arráez C, Ros Á, Linares J, Cerro L, Arráez MÁ. Ectopic recurrence of craniopharyngioma in the posterior fossa: Case report and review of the literature. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Characteristics of ectopic recurrence of craniopharyngioma: Case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Cai M, He H, Zhang B, Luo L, Gong J, Li W, Huang T, Guo Y. An Ectopic Recurrent Craniopharyngioma of the Temporal Lobe: Case Report and Review of the Literature. World Neurosurg 2019; 126:216-222. [PMID: 30877004 DOI: 10.1016/j.wneu.2019.02.196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ectopic recurrent craniopharyngioma is rare. We present a case of a temporal ectopic recurrent tumor after a trans-eyebrow supraorbital keyhole approach and provide a review of the reported data with basic statistics. METHODS We retrospectively reviewed 57 cases of craniopharyngiomas surgically treated at our institution. A temporal ectopic recurrent tumor with 10% high Ki-67 proliferation index expression was identified. The lesion underwent gross total resection without any complications. We also reviewed the related data and performed a basic statistical analysis. RESULTS Our review found 64 cases of ectopic recurrent craniopharyngioma that had been reported (including the present case). The median interval until ectopic recurrence was 4.0 years (interquartile range, 2.0-10.0). Of the 64 lesions, 48 (75%) were adamantinous, 6 (9%) were papillary, and 10 (16%) were unknown. Also, 34 tumors (53%) were located in the previous surgical tract, and 30 (47%) had disseminated along the cerebrospinal fluid pathway. Of the 64 ectopic tumors, 50 (78%) could be resected in total without complications. CONCLUSIONS Ectopic recurrent craniopharyngioma is a rare phenomenon. Meticulous protection of the entire surgical field and careful manipulation of the tumor during resection are required to prevent possible ectopic recurrence. Regular follow-up examinations are strongly recommended to detect any further recurrences. Gross total resection is the treatment of choice for ectopic recurrence.
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Affiliation(s)
- Meiqin Cai
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Haiyong He
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Baoyu Zhang
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Lun Luo
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jin Gong
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wensheng Li
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Tengchao Huang
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying Guo
- Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Nguyen B, Blasco M, Svider PF, Lin HS, Liu JK, Eloy JA, Folbe AJ. Recurrence of Ventral Skull Base Lesions Attributed to Tumor Seeding: A Systematic Review. World Neurosurg 2018; 124:S1878-8750(18)32927-9. [PMID: 30605757 DOI: 10.1016/j.wneu.2018.12.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate ventral skull base lesion recurrences along surgical access pathways attributed to iatrogenic seeding. METHODS A systematic review of the literature was performed searching for recurrence of ventral skull base lesions attributed to iatrogenic implantation. Studies were assessed for level of evidence. Primary intervention, pathology, and other clinical factors were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS Among 69 patients with recurrent skull base lesions attributed to seeding, the most common pathologies were craniopharyngioma (52.2%), chordoma (33.3%), adenocarcinoma (4.3%), adenoid cystic carcinoma (2.9%), and squamous cell carcinoma (2.9%). Median time to recurrence was 36 months. Time to recurrence was significantly longer for craniopharyngiomas than for chordomas (42 months vs. 24 months, P ≤ 0.05). Surgical approaches included craniotomy (62.0%), transseptal (11.3%), transfacial (12.7%), and transpalatal (4.2%). Mean time to recurrence after craniotomy was 69 months. Endoscopic/endoscopic-assisted approaches were used in 5 cases (7.0%). Commonly reported recurrence sites included subarachnoid (29.6%), dura (21.1%), incision (12.7%), septum (7.0%), and ethmoid sinuses (4.2%). CONCLUSIONS The potential for iatrogenic tumor seeding exists for numerous skull base lesions, most notably craniopharyngioma and chordomas. Routine surveillance may be necessary owing to significant latency intervals to ectopic recurrence. Although transnasal endoscopic techniques have been extensively employed in recent decades, only a handful of reported cases involve lesions originally treated with this approach. Further direct comparison of traditional approaches with endoscopic approaches may be invaluable in further elucidating the role of surgical technique in tumor implantation and recurrence.
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Affiliation(s)
- Brandon Nguyen
- Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, USA; Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
| | - Michael Blasco
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA; John D. Dingell VA Medical Center, Detroit, Michigan, USA; Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - James K Liu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Adam J Folbe
- Department of Otolaryngology, William Beaumont Hospital, Royal Oak, Michigan, USA; Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Renfrow JJ, Greeneway GP, Carter L, Couture DE. Intraventricular recurrence of a craniopharyngioma: case report. J Neurosurg Pediatr 2018; 22:393-396. [PMID: 29957141 DOI: 10.3171/2018.4.peds18112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Craniopharyngiomas frequently recur locally or less commonly along the path of prior resection. Ectopic recurrence is rare, although cases are reported along the neuraxis spanning from the subgaleal space down to the S1 nerve root. This case reports on a girl with a history of craniopharyngioma first resected at 23 months of age with two local suprasellar recurrences managed with repeat craniotomy and external beam radiation therapy. At age 14 she complained of worsening headaches and brain MRI demonstrated an enhancing 1.2-cm cystic lesion in the posterior body of the left lateral ventricle. Pathology following endoscopic resection of the lesion was consistent with an adamantinomatous craniopharyngioma. This case report serves to describe the first reported recurrence of a craniopharyngioma in the lateral ventricle and emphasizes the need for a high index of suspicion along with long-term follow-up of patients with a history of craniopharyngioma.
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Affiliation(s)
- Jaclyn J Renfrow
- 1Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and
| | - Garret P Greeneway
- 1Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and
| | - Lacey Carter
- 2Department of Neurological Surgery, University of Oklahoma, Oklahoma City, Oklahoma
| | - Daniel E Couture
- 1Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and
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Ectopic recurrence of pediatric craniopharyngiomas after gross total resection: a report of two cases and a review of the literature. Childs Nerv Syst 2016; 32:1523-9. [PMID: 26969175 DOI: 10.1007/s00381-016-3050-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/24/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Ectopic recurrent craniopharyngioma is rare. We reported two pediatric cases and reviewed the related literature. METHOD We retrospectively studied 177 craniopharyngioma cases treated by the senior author (Yuan X) between years 2003 and 2013. Two ectopic recurrent craniopharyngiomas were identified. One was discovered under the right frontal lobe and the other was found in the fourth ventricle. Both patients underwent a second radical resection without complications. Then we conducted an extensive review of peer-reviewed, English-language literatures in the US National Library of Medicine, focusing on the treatment modalities, recurrent sites, and clinical outcomes. RESULTS Sixty ectopic recurrent tumors have been reported so far (including this study). Thirty-three tumors were located in the previous surgical corridors and 27 were disseminated along the cerebrospinal fluid pathway. All recurrent tumors were surgically removed. The gross total resection (GTR) rates were 87 and 63 %, respectively. CONCLUSION The natural course of recurrent ectopic craniopharyngiomas is progressive. GTR is the treatment of choice. Regular follow-ups are strongly recommended to detect any further recurrence.
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Optic Chiasm Distortions Caused by Craniopharyngiomas: Clinical and Magnetic Resonance Imaging Correlation and Influence on Visual Outcome. World Neurosurg 2015; 83:500-29. [DOI: 10.1016/j.wneu.2014.10.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 06/14/2014] [Accepted: 10/04/2014] [Indexed: 11/17/2022]
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