Introduction: Craniopharyngiomas are histologically benign, but have a malignant clinical behavior.
Methods: A retrospective analysis of patients operated for Craniopharyngioma who were less than 18 years of age in our department was done. Patients were followed up to determine the recurrence rate and quality of life.
Results: 47 patients of Craniopharyngioma in the pediatric age group were treated in our hospital in the last 15 years. Most pediatric patients presented with features of raised ICP (81.5%). Out of the total 47 patients, near total excision was done in 83.9%, and partial excision in 16.1%. There was an overall mortality of 8.7%. The longest follow up time was 15 years and the shortest was 6 months. Overall recurrence rate was 23%. 23.8% who underwent near total excision and 16.6% who underwent subtotal excision with RT had recurrence.
Conclusions: Total excision should be attempted whenever a smooth microscopic dissection is possible. Whenever there is a risk of inflicting injury to the surrounding vital structures, one should settle for a sub-total or partial excision. Post op radiotherapy is preferred; except for those where total excision is confirmed by CTscan. In predominantly sellar lesions, complete tumor removal via extra cranial route (transsphenoidal approach) is attempted and in case of recurrence, transcranial surgery is performed and then radiotherapy is advised accordingly. The aim of treatment should always be to maintain optimal functional integrity.
Patient Care: By showing that transsphenoidal route is a better alternative to sellar paediatric craniopharyngiomas initially and reduces morbidity associated with transcranial surgery.
Learning Objectives: The objective was to study the outcome of patients after Craniopharyngioma surgery and attempt to formulate management strategies.