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Acta Neurochirurgica

Published in:

01-12-2011 | Review Article

Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category

Authors: José M. Pascual, Ruth Prieto, Rodrigo Carrasco

Published in: Acta Neurochirurgica | Issue 12/2011

Abstract

Purpose

This study investigates retrospectively the clinical, neuroradiological, pathological and surgical evidence verifying the infundibulo-tuberal topography for craniopharyngiomas (CPs). Infundibulo-tuberal CPs represent a surgical challenge due to their close anatomical relationships with the hypothalamus. An accurate definition of this topographical category is essential in order to prevent any undue injury to vital diencephalic centres.

Methods

A systematic review of all scientific reports involving pathological, neuroradiological or surgical descriptions of either well-described individual cases or large series of CPs published in official journals and text books from 1892 to 2011 was carried out. A total of 1,232 documents providing pathological, surgical and/or neuroradiological evidence for the infundibulo-tuberal or hypothalamic location of CPs were finally analysed in this study.

Findings

For a total of 3,571 CPs included in 67 pathological, surgical or neuroradiological series, 1,494 CPs (42%) were classified as infundibulo-tuberal lesions. This topography was proved in the autopsy of 122 non-operated cases. The crucial morphological finding characterizing the tubero-infundibular topography was the replacement of the third ventricle floor by a lesion with a predominant intraventricular growth. This type of CP usually presents a circumferential band of tight adherence to the third ventricle floor remnants, formed by a functionless layer of rective gliosis of a variable thickness. After complete surgical removal of an infundibulo-tuberal CP, a wide defect or breach at the floor of the third ventricle is regularly observed both in the surgical field and on postoperative magnetic resonance imaging studies.

Conclusions

Infundibulo-tuberal CPs represent a major topographical category of lesions with a primary subpial development at the floor of the third ventricle. These lesions expand within the hypothalamus itself and subsequently occupy the third ventricle; consequently, they can be classified as not strictly intraventricular CPs. A tight attachment to the hypothalamus and remnants of the third ventricle floor is the pathological landmark of infundibulo-tuberal CPs.

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Title: Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category
Authors: José M. Pascual
Ruth Prieto
Rodrigo Carrasco
Publication date: 01-12-2011
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-011-1149-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category

Abstract

Purpose

Methods

Findings

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Findings

Conclusions

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