PubMed · 7105362
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P Castier, C Lenski, M Jomin, F Evrard. 1982. [Bitemporal hemianopsic scotoma].. https://pubmed.ncbi.nlm.nih.gov/7105362/
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The variable clinical presentation, relation to vital anatomic structures, and complications associated with treatment contribute to the controversies that surround the management of craniopharyngiomas. Although the results with radiation therapy and radiosurgery have been equal to or better than those obtained with aggressive surgery, considerable debate exists regarding the role of surgery alone versus limited surgery followed by radiation therapy. Based on current data, one may consider using surgery for discrete tumors that do not involve the hypothalamus and for which gross total resection would result in minimal cognitive side effects. For tumors that clearly involve the hypothalamus and associated suprasellar structures, subtotal resection followed by radiation therapy tailored for the residual disease seems to offer the best long-term control rates with acceptable morbidity.
BACKGROUND: Craniopharyngioma is histologically a benign epithelial tumor located in the supersellar cistern that often presents aggressive growth and repeated recurrence. The authors hypothesized that craniopharyngioma recurrence and invasive growth are angiogenesis dependent and evaluated the significance of vascularization in the prognosis of craniopharyngioma by a prospective cohort study. METHODS: The cohorts consisted of 32 patients with AE and 31 patients with SP tumor. The primary and recurrence removal specimens of the cohort patients were gathered. Microvascular density and VEGF protein in the recurrence group and recurrence-free group were detected by the immunohistochemistry avidin-biotin-peroxidase method and analyzed quantitatively through computer-assisted microscopy to evaluate the correlation of MVD and VEGF with prognosis of craniopharyngiomas. RESULTS: The average follow-up phase was 63.34 months; 14 of 32 patients with AE and 6 of 31 patients with SP had recurrence and underwent operation again. Although MVD and VEGF have significant difference between AE and SP (P=.000, P=.018, respectively), MVD and VEGF have no statistical difference between the recurrence group and recurrence-free group (P>.05). CONCLUSIONS: Microvascular density and VEGF in craniopharyngioma tissue have no correlation with prognosis of the tumor, which may be explained by the minimal blood circulation in the craniopharyngioma. Adamantine epithelioma showed more tendency to recur than SP.