Craniopharyngiomas: 20-year-period evaluation study

Abstract

Background & Objective: Craniopharyngioma is a rare histologically benign brain tumour with potential malignant clinical course because of the high propensity of recurrence, deriving from the remnants of Rathe’s pouch, presenting as solid mass and partly as fluid-filled cyst. There are two main histological subtypes: adamantinous and papillary. The aim of this study is to evaluate statistical features of this tumour in the Republic of Macedonia. Method: This is a 20-year-period retrospective evaluation study (1998-2018) of 40 craniopharyngioma cases operated in the University Neurosurgery Clinic, diagnosed at the Institute of Pathology, Medical Faculty-UKIM, Skopje, Macedonia on paraffin-embedded section slides routinely stained with H&E. Statistica for Windows 7 was used. Results: From total 4929 cases of benign and malignant brain tumours, 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 common localization: sellar region - 11(27.5%), cerebrum – 8(20%). Adamantinous - 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 tumour (first 1-3 years). Adamantinous 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 and correlation between gender, age and histological subtype. Papillary craniopharyngioma appears more frequently in males and adamantinous was most prevalent in younger patients.