Craniopharyngioma has a bimodal age distribution, with a notable second incidence peak in adults between the ages of 55 and 69. This protocol addresses the management of craniopharyngioma specifically in adult patients (age 18 years or older).
Adult patient (age ≥18) with confirmed craniopharyngioma. Surgical planning is individualized according to the tumour's anatomical location, pattern of extension, and its relationship to surrounding critical structures.
Treatment is based on surgical resection, with the operative route selected according to tumour extension. Different approaches — including endonasal and transcranial techniques — are considered depending on tumour anatomy. When hypothalamic infiltration is present, the extent of resection is adjusted to limit morbidity. The complete approach algorithm, with the decision criteria for each route and scenario, is available in the full protocol.
The age distribution of CP is bimodal, with a first peak in incidence observed in children (between the ages of 5 and 10), and a second peak in adults (between the ages of 55 and 69).
In children and adults, the endonasal approach is recommended as the first-line approach for resection of craniopharyngiomas with median, suprasellar and retro-chiasmatic extension (strong).
In the event of infiltration of the hypothalamus, subtotal resection should be preferred, leaving one or more remnants in contact with the hypothalamus.
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