Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2024 Mar;74(3 (Supple-3)):S126-S134. doi: 10.47391/JPMA.S3.GNO-15.
Craniopharyngiomas are benign, extra-axial epithelial tumours originating from the pituitary stalk, impacting areas such as the hypothalamus, optic chiasm, and various cranial nerves. These tumours present unique surgical challenges due to their proximity to critical neurovascular structures. Management typically involves maximal safe resection as the primary approach. However, in low- and middle-income countries (LMICs), factors like late presentation, higher risks of endocrine and visual complications, frequent recurrence, and potential for incomplete resection complicate treatment. These challenges are exacerbated by limited access to specialised expertise and surgical equipment, increasing the risk of damage during surgery compared to High- Income Countries. This manuscript outlines management guidelines tailored for LMICs, emphasizing that a combination of surgical resection and chemoradiation therapy, as advised by a neuro-oncology tumour board, often yields the best outcomes.
颅咽管瘤是起源于垂体柄的良性、外轴上皮肿瘤，影响下丘脑、视交叉和各种颅神经等区域。由于其靠近关键的神经血管结构，这些肿瘤带来了独特的手术挑战。管理通常涉及最大安全切除作为主要方法。然而，在低收入和中等收入国家（LMICs），由于晚期出现、内分泌和视觉并发症风险较高、频繁复发以及可能不完全切除等因素，治疗变得复杂。这些挑战因缺乏专业知识和手术设备而加剧，与高收入国家相比，手术过程中的损伤风险增加。本文概述了针对 LMICs 的管理指南，强调由神经肿瘤学肿瘤委员会建议的手术切除和放化疗相结合，通常会产生最佳结果。
