Ectopic Occurrence of Craniopharyngiomas

Craniopharyngiomas are among the most complex tumors treated by neurosurgeons. Aggressive surgical management can lead to increased morbidity and mortality. Less invasive strategies which combine subtotal resection with local radiotherapy have proven effective, although endoscopic techniques could provide wider extent of resection with potentially decreased morbidity. Craniopharyngiomas are thought to arise from retained epithelial cell remnants after closure of the craniopharyngeal duct or from metaplasia of epithelial cells of the anterior lobe of the pituitary. Their most frequent location is in the sellar region, although there is extensive evidence that craniopharyngiomas can appear in ectopic locations. This can happen through direct anatomical seeding of cells during surgery for the removal of a sellar craniopharyngioma, secondary spread of the tumor after surgery to a distant location not related to the initial surgical approach, or the primary development of the tumor in a completely extrasellar location.