Introduction: The epidemiology and management of craniopharyngiomas in Puerto Rico remains unknown, with limited information published on this subject worldwide, and no available publications specifically concerning Puerto Rico. Due to the variability of craniopharyngioma behavior and low incidence of the disease, there is no general consensus on best management practices. The purpose of this study is to describe the epidemiology, management, and treatment outcomes of craniopharyngiomas in Puerto Rico.
Methods: A descriptive study of cranipharyngioma patients at the Puerto Rico Medical Center between years 2004-2014 was performed. Data collected retrospectively from medical records included: town of residency, gender, age at time of diagnosis, recurrence, tumor subtype and location, clinical manifestations, tumor management, and treatment outcomes. Initially, a total 34 patients were identified, and 21 of them fulfilled our inclusion criteria of: age over 21 and pathology consistent with craniopharyingioma.
Results: Mean age was 51 years (95% CI, 45.6 - 58.1), and 86% of patients were under the age of 65. Incidence rate for the 11 year period was 7.18 per million persons (95% CI, 6.51 – 7.85). 57% of the subjects were female and 43% were male. 29% of the tumors were pathologically described as adamantinomatous, while the rest (71%) remained unspecified. The most common tumor localization was suprasellar (52%), and the most performed treatment was transcranial resection (90%). Central diabetes insipidus was the most common post-operative complication (57%). 33% of patients presented with at least one recurrence.
Conclusions: The mean age at time of diagnosis in Puerto Rican adult population was significantly lower than the one observed in literature, not presenting the expected bimodal distribution. The identified tumor subtype in adult population was consistent with tumor subtype suggestive of juvenile disease. The preferred surgical approach was transcranial resection, with one-third of patients presenting at least one recurrence. Post operatory diabetes insipidus was the most common surgical outcome in patients who underwent transcranial tumor resection.
Patient Care: By describing the epidemiology and management of craniopharyngiomas in Puerto Rican adult population, neurosurgeons can gain a better understanding of the different treatment modalities being performed and the outcomes observed. This will aid in providing better treatment recommendations for the patients, resulting in better surgical outcomes, and reduced adverse effects.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the epidemiology of Craniopharyngiomas in Puerto Rican population, 2) Discuss the treatments being performed on adult patients with craniopharyngiomas, 3) Identify the treatments that provide better outcomes with reduced complications
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