Craniopharyngioma: history

One of the most challenging parasellar tumors, the craniopharyngioma was first described by Friedrich Albert von Zenker in 1857. Following improved understanding of pituitary gland physiology and development, Jakob Erdheim became the first to accurately describe the histopathological characteristics of a craniopharyngioma. Babinski’s described the clinical presentation of these patients, with “sexual infantilism and dystrophic adiposity.” The first successful surgical resection of a craniopharyngioma was performed by A. E. Halstead of Chicago of July 21st, 1909. Harvey Cushing embraced the transsphenoidal approach for the majority of his pituitary operations, but favored the transcranial approach for craniopharyngiomas. The introduction of antibiotics, corticosteroids, and microscopy significantly improved surgical outcomes. As technology improved, trans-cranial and transsphenoidal approaches were implemented depending on tumor characteristics. Adjuvant therapy, such as stereotactic radiosurgery, radioisotope brachytherapy, and intracapsular chemotherapy have improved overall tumor control rates and decreased the incidence of complications. Building on over 100 years of surgery for “the most formidable of intracranial tumors,” results continue to improve. Regardless, challenges continue to remain requiring surgical insight and innovation.