Article

Craniopharyngiomas (CPs) are benign epithelial tumors that develop along the
hypothalamus-hypophyseal axis and were first described by Jakob Erdheim in 1904.
These tumors have represented a challenge for surgeons since the rise of modern
neurosurgery. The study of CPs is linked to the development of this surgical
discipline in parallel with neuroendocrinology within the French school of
neurology, led by Joseph Babinski. For the present study, all CP cases published
in the French scientific literature before the development of modern
neuroradiology were gathered, and 65 cases that underwent surgical procedures
between 1921 and 1973 were selected. From our analysis of them, useful
information has been obtained that can be applied to the management of CPs today.
Most tumors were adamantinomatous CPs (62 patients) with an infundibulo-tuberal
location (40.6%). The most frequent surgical route employed was subfrontal (69%).
Selection of the surgical approach and degree of removal did not appear to have
been influenced by the presumed topography of the tumor, and resulted in a poor
outcome in 47% of patients. However, the authors were able to recognize the
presence of symptoms indicating that the tumor had caused hypothalamic and/or
infundibular damage, such as seen in the infundibulo-tuberal syndrome, first
described by Claude and Lhermitte in 1917. At present, the optimal surgical
approach and degree of removal are still the subject of debate, although the
presence of clinical signs pointing to hypothalamic involvement by CPs should
always be preoperatively accurately assessed to improve surgical outcomes.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS