Craniopharyngiomas: A 20-Year-Period Evaluative Single Center Study

Abstract

Introduction: Craniopharyngioma is a rare histologically benign brain tumor with potential malignant clinical course because of the high propensity of recurrence, deriving from the remnants of Ratkhe’s pouch, presenting as solid mass and partly as fluid-filled cyst. There are two main histological subtypes: adamantinomatous and papillary. The aim of this study is to evaluate statistical features of this tumor in the Republic of North Macedonia. Materials and Methods: This is a 20-year-period retrospective, single center evaluative study (1998-2018) of 40 craniopharyngioma cases operated in the University Clinic of Neurosurgery, diagnosed at the Institute of Pathology, Medical Faculty, University ‘’Ss. Cyril and Methodius’’ in Skopje, Republic of North Macedonia on paraffin section slides routinely stained with H&E. Statistica for Windows 7 was used. Results: From total 4929 cases of benign and malignant brain tumors, craniopharyngioma comprise 40 cases (0.81%); 25 (62.5%) males (37.9 ± 17.8 years), 15 (37.5%) females (34.0 ± 25.4 years), age 3 to 68 years; Most prevalent localization: Sellar region - 11 (27.5%), cerebrum - 8 (20%). Adamantinomatous - 27 (67.5%) cases, papillary 13 (32.5%) cases. Age group distribution: the most cases - 7 (17.5%) in 0-9, 40-49, 60-69 years groups; least cases - 3 (7.5%) in 20-29 years group. Nine (22.5%) of 40 patients have had recurrent tumor (first 1-3 years). Adamantinomatous was diagnosed in 14 (51.85%) males and 13 (48.15%) females; Papillary in 11 (84.62%) males and 2 (15.38%) females. There is significant statistical difference between age groups and craniopharyngioma subtypes (Kruskal-Wallis ANOVA: H = 14.86; p = 0.0274). Conclusion: We found association/correlation between gender, age and histological subtype. Papillary craniopharyngioma appears more frequently in males and adamantinomatous was most prevalent in younger patients.