Clinical, Radiological, and Molecular Insights into Craniopharyngioma

Dear Colleagues,

The sellar region is of particular interest to neurosurgeons and encompasses a variety of conditions, including pituitary adenomas, craniopharyngiomas, aneurysms, astrocytomas, and meningiomas. Among these, craniopharyngioma remains one of the most challenging entities. It is a slow-growing, benign intracranial tumor, but it exhibits locally invasive behavior, complicating treatment and prognosis.

One of the major difficulties with craniopharyngioma is its high recurrence rate, which can reach up to 50%. Identifying risk factors for recurrence is a significant area of current research. Surgical approach selection is critical, and preserving the pituitary stalk during surgery has been associated with better functional outcomes but can increase the risk of tumor persistence or recurrence. Gross total resection (GTR) remains the goal for reducing recurrence, although subtotal resection (STR) followed by adjuvant radiotherapy (XRT) is also considered in cases where complete resection may lead to serious complications.

In addition to surgical and radiological advances, new adjuvant therapies are being explored to address the challenging nature of craniopharyngioma. Intratumoral therapy with sclerosing agents, such as bleomycin, has been trialed, and targeted therapies, including inhibitors for BRAF, MEK, and interleukin-6, are under investigation. However, the long-term efficacy and safety of these treatments are still uncertain, highlighting the need for further studies to evaluate their potential.

Furthermore, a deeper understanding of the histopathologic subtypes of craniopharyngioma is also crucial. Current research aims to clarify how these subtypes influence tumor behavior, recurrence risk, and response to therapies. As a result, future studies are essential for improving diagnostic precision, refining therapeutic approaches, and enhancing long-term outcomes for patients with this complex tumor.

Further investigation into the clinical, radiological, molecular, and therapeutic aspects of craniopharyngioma is essential to better understand and manage this condition.

Dr. Ernest Jan Bobeff
Dr. Bartosz Szmyd
Guest Editors

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• neuro-oncology
• brain tumors
• skull base
• craniopharyngioma
• stalk