Parasellar tumors in children. II. Surgical management, radiation therapy, and follow-up.

Despite the predominance of histologically benign tumors in the parasellar region of children, their proximity to the hypothalamus, optic nerves and tracts, and the internal carotid artery and its branches often renders surgical removal exceptionally difficult. The possible presence of a variety of tumor types makes biopsy verification of tumor diagnosis essential. The surgical management, radiotherapeutic treatment, and clinical follow-up of a group of 74 children whose preoperative findings were reviewed in the preceding paper are presented to illustrate the management of four major tumor types encountered: craniopharyngioma, pituitary adenoma, germinoma, and diencephalic glioma. Both subfrontal and transsphenoidal surgical approaches were used. Although total resection of benign tumors is desirable, prudent use of a variety of techniques can achieve effective neurosurgical management and optimal long-term results.