Craniopharyngiomas are usually part solid mass
and part fluid
-filled cyst. They are benign
(not cancer) and do not spread to other parts of the brain or to other parts of the body. However, they may grow and press on nearby parts of the brain or other areas, including the pituitary gland, the optic chiasm, optic nerves, and fluid-filled spaces in the brain. Craniopharyngiomas may affect many functions of the brain. They may affect hormone
making, growth, and vision. Benign brain tumors
Tests that examine the brain, vision, and hormone levels are used to detect (find) childhood craniopharyngiomas.
The following tests and procedures may be used:
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
Visual field exam: An exam to check a person’s field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). Any loss of vision may be a sign of a tumor that has damaged or pressed on the parts of the brain that affect eyesight.
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues
show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
(magnetic resonance imaging) of the brain and spinal cord with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the brain. A substance called gadolinium is injected into a vein. The gadolinium collects around the tumor cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Blood chemistry studies: A procedure in which a blood
sample is checked to measure the amounts of certain substances released into the blood by organs and tissues
in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Blood hormone studies: A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. For example, the blood may be checked for unusual levels of thyroid-stimulating hormone
(TSH) or adrenocorticotropic hormone
(ACTH). TSH and ACTH are made by the pituitary gland in the brain.
Childhood craniopharyngiomas are diagnosed and may be removed in the same surgery.
Doctors may think a mass
is a craniopharyngioma based on where it is in the brain and how it looks on a CT scan or MRI. In order to be sure, a sample of tissue is needed.
One of the following types of biopsy
procedures may be used to take the sample of tissue:
: A hollow needle is inserted through a hole in the skull
into the brain.
Computer-guided needle biopsy
: A hollow needle guided by a computer is inserted through a small hole in the skull into the brain.
Transsphenoidal biopsy: Instruments are inserted through the nose and sphenoid
bone (a butterfly-shaped bone at the base of the skull) and into the brain.
views the tissue under a microscope
to look for tumor cells. If tumor cells are found, as much tumor as safely possible may be removed during the same surgery.
The following laboratory test
may be done on the sample of tissue that is removed:
Immunohistochemistry: A test that uses antibodies
to check for certain antigens
in a sample of tissue. The antibody is usually linked to a radioactive
substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.