Cystic Craniopharyngioma: Surgical Treatment by Endonasal Approach

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CRANIOPHARYNGIOMAS are benign pituitary tumors that arise from Rathke's pouch. These tumors usually are cystic, but may be solid. Many other names have been given to these tumors, including Rathke's pouch cysts or tumors, hypophyseal duct cysts or tumors, suprasellar cysts or tumors, adamantinomas, and epitheliomas. Craniopharyngiomas need not be difficult to diagnose, but they always are difficult to treat.

This report presents the case history of a patient whose cystic craniopharyngioma was treated by endonasal sphenoidostomy and aspiration of the tumor mass.

Report of Case

A 35-year-old Negro man was first seen at the Cleveland Clinic in December 1947. His chief complaint was loss of libido, which he had first noted five years earlier. His history revealed that, approximately three years before examination, while serving in the Armed Forces in October 1944, he had noted loss of vision in the lateral area of the left eye. A brain tumor had been diagnosed, and a right frontal craniotomy had been performed in 1945 in an Army hospital. After surgery the sight in the left eye had improved, but vision in the right eye had decreased. He had been unable to read or to distinguish the features of people, but he had been able to get around by himself. When he was initially seen at the Clinic, the diagnosis of impotence probably secondary to suprasellar tumor was made. Testosterone propionate, 25 mg. three times weekly for three weeks, and 50 mg. three times weekly for three additional weeks, was administered, without. . .



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