Lonjon M, Dran G, Casagrande F, Vandenbos F, Mas J C, Richelme C
Department of Neurosurgery, Hospital Pasteur, UNSA, 30 Avenue de la Voie Romaine, 06002, Nice, France.
Childs Nerv Syst. 2005 Mar;21(3):177-80. doi: 10.1007/s00381-004-1019-y. Epub 2004 Jul 30.
A case of the antenatal diagnosis of a craniopharyngioma with radical surgery in the neonatal period is reported.
We have reviewed the literature of such cases in an attempt to isolate specific features in this age group and to determine the appropriate management. Only six cases of the truly antenatal diagnosis of craniopharyngiomas have been reported. Diagnosis has resulted from routine ultrasound during pregnancy or from polyhydramnios. Clinically, there is often macrocephaly due to hydrocephalus or a significant-sized tumor.
Management of these rare cases is controversial with high postoperative mortality and significant morbidity, including panhypopituitarism, visual disturbance, and neuropsychological disorders. From the available literature, no conclusions concerning the management can be drawn at present, due to the rarity of early surgical intervention. Our case, despite the lack of important follow-up, seems to confirm the possibility of attempting radical surgery in the neonatal period as a result of advances both in surgical techniques and in neonatal intensive care.