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Ahmed N, Azam MI. Isolated fourth ventricle craniopharyngioma: Representative case illustration and review of literature. Surg Neurol Int 2023; 14:416. [PMID: 38213460 PMCID: PMC10783684 DOI: 10.25259/sni_719_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/29/2023] [Indexed: 01/13/2024] Open
Abstract
Background Sella and suprasellar areas are frequently affected by craniopharyngiomas. In this article, eight occurrences have been documented. One is new, and the remaining seven are from previously published articles. Their prevalence in the posterior fossa without expansion from the suprasellar area is unusual. Case Description We present a case of a primary 4th ventricular craniopharyngioma of the posterior fossa in a 16-year-old male with no association with Gardner's syndrome. He presented with sudden deterioration of consciousness level and was diagnosed as having a homogeneously contrast enhancing lesion occupying the 4th ventricle with obstructive hydrocephalus. The patient underwent emergency placement of external ventricular drain followed by complete removal of the tumor on the next day by midline suboccipital craniotomy with telovelar approach. Histopathological features were consistent with the adamantinomatous variety of craniopharyngioma. He had complete neurological recovery and no evidence of tumor recurrence in 1-year follow-up. Conclusion The craniopharyngioma in our case was distinct because it was a solid tumor with no cystic component, exhibited homogeneous contrast enhancement in neuroimaging, developed in the fourth ventricle, and reached the level of foramen magnum, features that had rarely been documented previously. We also reviewed the literature on reported cases of 4th ventricular craniopharyngioma to strengthen knowledge in this area and highlight the embryological basis of ectopic craniopharyngioma.
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Affiliation(s)
- Nazmin Ahmed
- Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Shahbag, Dhaka, Bangladesh
| | - Md. Isma Azam
- Department of Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
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Uemura H, Tanji M, Natsuhara H, Takeuchi Y, Hoki M, Sugimoto A, Minamiguchi S, Kawasaki H, Torishima M, Kosugi S, Mineharu Y, Arakawa Y, Yoshida K, Miyamoto S. The association of ectopic craniopharyngioma in the fourth ventricle with familial adenomatous polyposis: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21572. [PMID: 36130581 PMCID: PMC9379701 DOI: 10.3171/case21572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Craniopharyngioma (CP) often arises in the sellar and suprasellar areas; ectopic CP in the posterior fossa is rare. Familial adenomatous polyposis (FAP) is a genetic disorder involving the formation of numerous adenomatous polyps in the gastrointestinal tract, and it is associated with other extraintestinal manifestations. OBSERVATIONS The authors reported the case of a 63-year-old woman with FAP who presented with headache and harbored a growing mass in the fourth ventricle. Magnetic resonance imaging (MRI) findings revealed a well-circumscribed mass with high intensity on T1-weighted images and low intensity on T2-weighted images and exhibited no contrast enhancement. Gross total resection was performed and histopathology revealed an adamantinomatous CP (aCP). The authors also reviewed the previous reports of ectopic CP in the posterior fossa and found a high percentage of FAP cases among the ectopic CP group, thus suggesting a possible association between the two diseases. LESSONS An ectopic CP may be reasonably included in the differential diagnosis in patients with FAP who present with well-circumscribed tumors in the posterior fossa.
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Affiliation(s)
- Hiroya Uemura
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Natsuhara
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuhide Takeuchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Masahito Hoki
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Akihiko Sugimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | | | | | - Shinji Kosugi
- Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Vitulli F, D’Avella E, Solari D, Franca RA, Romano A, Bonavolontà P, Cavallo LM. Primary ectopic orbital craniopharyngioma. Acta Neurochir (Wien) 2021; 164:1979-1984. [PMID: 34467436 DOI: 10.1007/s00701-021-04969-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Craniopharyngiomas (CP) ectopic localizations off the midline outside the sellar-suprasellar region are very rare and most often associated to secondary tumor dissemination, being primary ectopic CPs extremely unusual. We herein report the first case of a primary ectopic craniopharyngioma within the orbit. A 15-year-old patient presented with progressive right ptosis, proptosis, and retro ocular pain. Magnetic resonance imaging (MRI) showed a predominantly cystic lesion, occupying the superolateral right corner of the orbit, outside the intraconal space with no evidence of intracranial involvement. An endoscopic transorbital eyelid approach was adopted. Pathology report disclosed a primary ectopic craniopharyngioma.
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Dahl NA, Pratt D, Camelo-Piragua S, Kumar-Sinha C, Mody RJ, Septer S, Hankinson TC, Chinnaiyan AM, Koschmann C, Hoffman L. Pediatric craniopharyngioma in association with familial adenomatous polyposis. Fam Cancer 2019; 18:327-330. [PMID: 30919136 DOI: 10.1007/s10689-019-00126-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome driven by germline loss-of-function of the APC gene and phenotypically manifests with intestinal polyposis and a variety of extra-intestinal bone and soft tissue tumors. Craniopharyngioma is not a well-described FAP-associated tumor, however, six cases have been reported in adults, all demonstrating ectopic location and adamantinomatous histology. We report the first case of craniopharyngioma associated with FAP in a pediatric patient. A seven-year-old girl who presented with headache and vomiting was found on magnetic resonance imaging to have a suprasellar mass with cystic extension to the pre-pontine space. The tumor represented an adamantinomatous craniopharyngioma (aCP) with nuclear β-catenin expression. Whole exome sequencing confirmed a CTNNB1 activating point mutation and a germline APC frameshift variant. This case represents the first FAP-associated craniopharyngioma in childhood…. expanding our understanding of the molecular underpinnings driving tumorigenesis in this unique patient.
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Affiliation(s)
- Nathan A Dahl
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA. .,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA. .,Department of Pediatrics, University of Colorado School of Medicine, 12800 E 19th Ave, Aurora, CO, 80045, USA.
| | - Drew Pratt
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Sandra Camelo-Piragua
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Chandan Kumar-Sinha
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Rajen J Mody
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Seth Septer
- Pediatric Gastroenterology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Todd C Hankinson
- Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA.,Departments of Neurosurgery and Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arul M Chinnaiyan
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Carl Koschmann
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Lindsey Hoffman
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA
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Craneofaringioma ectópico y síndrome de Gardner: a propósito de un caso y revisión de la literatura. Neurocirugia (Astur) 2017; 28:97-101. [DOI: 10.1016/j.neucir.2016.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 12/20/2022]
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Gabel BC, Cleary DR, Martin JR, Khan U, Snyder V, Sang U H. Unusual and Rare Locations for Craniopharyngiomas: Clinical Significance and Review of the Literature. World Neurosurg 2016; 98:381-387. [PMID: 27908738 DOI: 10.1016/j.wneu.2016.10.134] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study discusses rare and unusual locations of primary craniopharyngiomas. METHODS We describe a case of a craniopharyngioma in the cerebellopontine angle. As a result of this unusual location, we performed a literature review of the ectopic occurrence of craniopharyngiomas using Pubmed, Cochrane Database, Trip, and Google Scholar to search for the terms "unusual," "uncommon," and "ectopic" in combination with "craniopharyngioma." The bibliographies of relevant articles were also searched. RESULTS We found 28 reported cases of rare anatomic locations for primary craniopharyngiomas. The average age of the patients was 30.8 years. Several patients had Gardner syndrome. CONCLUSIONS Craniopharyngiomas are most often located in the suprasellar region. Presentation in sites outside the parasellar region is rare. Among these ectopic sites, the cerebellopontine angle appears to be the most common location.
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Affiliation(s)
- Brandon C Gabel
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA.
| | - Daniel R Cleary
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Joel R Martin
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Usman Khan
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Vivian Snyder
- Division of Neuropathology, Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Hoi Sang U
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
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