de Quintela Vittor Sérgio Santos, Almeida Sofia Morais Silva, do Nascimento Arthur Campos, Melo Nelson Almeida D'Ávila, Oliveira Arthur Maynart Pereira
Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.
Department of Medicine, Universidade Tiradentes, Aracaju, Brazil.
Surg Neurol Int. 2025 May 2;16:161. doi: 10.25259/SNI_134_2025. eCollection 2025.
Craniopharyngiomas are benign epithelial tumors that arise along the craniopharyngeal duct, commonly located in the sellar or suprasellar region. Infrasellar extension is a rare variant and may involve the nasopharynx, sphenoid sinus, clivus, and pterygopalatine fossa.
A 66-year-old male patient is presented to the otorhinolaryngology service due to a complaint of left ear obstruction for the past 4 months. After no response to clinical treatment, investigation with computed tomography and magnetic resonance imaging showed a heterogeneous lesion with areas of calcification and bone destruction located in the sphenoid sinus region, which projected inferiorly and laterally invading the clivus in its entirety, the petrous apex, middle fossa, pterygopalatine, and infratemporal fossae with no involvement of the sellar/suprasellar region. The patient was referred to a multidisciplinary skull base surgery group that performed an extended transpterygoid endoscopic endonasal approach with gross total resection. The anatomopathological study was consistent with adamantinomatous craniopharyngioma.
We present a rare case of a giant infrasellar craniopharyngioma with extensive invasion of the skull base without involvement of the sella or the pituitary gland.
颅咽管瘤是沿颅咽管发生的良性上皮性肿瘤，通常位于鞍区或鞍上区。鞍下扩展是一种罕见的变异情况，可能累及鼻咽、蝶窦、斜坡和翼腭窝。
一名66岁男性患者因过去4个月来左耳堵塞的主诉就诊于耳鼻喉科。临床治疗无效后，计算机断层扫描和磁共振成像检查显示蝶窦区域有一个不均匀的病变，伴有钙化和骨质破坏区域，该病变向下和向外突出，完全侵犯斜坡、岩尖、中颅窝、翼腭窝和颞下窝，鞍区/鞍上区未受累。该患者被转诊至一个多学科颅底手术小组，该小组采用扩大经翼点内镜鼻内入路进行了全切除。解剖病理学研究结果符合成釉细胞瘤型颅咽管瘤。
我们报告了一例罕见的巨大鞍下颅咽管瘤，广泛侵犯颅底但未累及蝶鞍或垂体。
