Craniopharyngiomas
A craniopharyngioma is a benign tumour that arises at the base of your brain near a gland called the pituitary gland. It usually occurs in children under 14 years old and in adults older than 45. These tumours are usually cystic (fluid filled) structures but may be more solid in adults.
Craniopharyngiomas are thought to develop from remnant cells of the developmental process. Growth is slow and may not be noticed until the tumour is fairly large or compresses on important structures. Increased pressure can cause personality changes, headache, vomiting and confusion. A craniopharyngioma may also affect:
- The pituitary gland, leading to hormonal imbalance, affecting growth, fatigue, sensitivity to cold, delayed puberty, abnormal menstruation or loss of sexual desire, nausea, constipation, low blood pressure, diabetes insipidus and depression.
- The optic nerve responsible for vision.
- The hypothalamus(region at the base of the brain, near pituitary gland), causing drowsiness, obesity and problems with temperature regulation.
When you present to the clinic, your doctor will review your symptoms and perform a thorough physical examination. Neurological and psychiatric functions tests, blood tests to check hormone levels, and a visual field exam are usually ordered. Imaging studies such as a CT or MRI are ordered to view the tumour and structures affected.
Surgical removal of the tumour is the first line of treatment. The goal is to prevent any damage to surrounding structures and preserve as much pituitary gland, visual, and brain function as possible. During surgery, a tube may be placed in your skull to drain any excess fluid and relieve pressure. If the tumour is too close to an important structure and complete removal is not possible, radiation treatment is indicated to minimize the tumour. You are advised to have periodic follow-ups to check for recurrence and hormonal imbalances which may result from the tumour and radiation treatments.
