Craniopharyngioma classification: Difference between revisions

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**It consists of [[Reticular|reticular epithelial]] cells which have appearances reminiscent of the [[enamel]] [[Pulp (tooth)|pulp]] of developing teeth.
**It consists of [[Reticular|reticular epithelial]] cells which have appearances reminiscent of the [[enamel]] [[Pulp (tooth)|pulp]] of developing teeth.
**There may be single or multiple [[cysts]] filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**There may be single or multiple [[cysts]] filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**"Wet [[keratin]] nodules" are a characteristic histological feature.
**"Wet [[keratin]] nodules" are a characteristic histological feature.<ref name="pmid1260697">{{cite journal |vauthors=Petito CK, DeGirolami U, Earle KM |title=Craniopharyngiomas: a clinical and pathological review |journal=Cancer |volume=37 |issue=4 |pages=1944–52 |date=April 1976 |pmid=1260697 |doi= |url=}}</ref>
**[[Calcification]] is usually present in 90%
**[[Calcification]] is usually present in 90%
**They are more locally aggressive.
**They are more locally aggressive.
**It has higher rate of recurrence.
**It has higher rate of recurrence.
**Activating beta-catenin [[gene]] mutations are found in adamantinomatous tumors.
**Activating beta-catenin [[gene]] mutations are found in adamantinomatous tumors.<ref name="pmid10690718">{{cite journal |vauthors=Duff J, Meyer FB, Ilstrup DM, Laws ER, Schleck CD, Scheithauer BW |title=Long-term outcomes for surgically resected craniopharyngiomas |journal=Neurosurgery |volume=46 |issue=2 |pages=291–302; discussion 302–5 |date=February 2000 |pmid=10690718 |doi= |url=}}</ref>




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**The [[Papilla|papillary]] subtype is seen almost exclusively in adults.<ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>
**The [[Papilla|papillary]] subtype is seen almost exclusively in adults.<ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>
**It is formed of masses of metaplastic [[squamous cell]]s.
**It is formed of masses of metaplastic [[squamous cell]]s.<ref name="pmid1260697">{{cite journal |vauthors=Petito CK, DeGirolami U, Earle KM |title=Craniopharyngiomas: a clinical and pathological review |journal=Cancer |volume=37 |issue=4 |pages=1944–52 |date=April 1976 |pmid=1260697 |doi= |url=}}</ref>
**"Wet [[keratin]]" nodule is absent.
 
**"Wet [[keratin]]" nodule is absent.<ref name="pmid9761047">{{cite journal |vauthors=Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM |title=The descriptive epidemiology of craniopharyngioma |journal=J. Neurosurg. |volume=89 |issue=4 |pages=547–51 |date=October 1998 |pmid=9761047 |doi=10.3171/jns.1998.89.4.0547 |url=}}</ref>
**[[Cysts]] do form, but these are less of a feature, and the tumor is more ''solid''.<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**[[Cysts]] do form, but these are less of a feature, and the tumor is more ''solid''.<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**[[Calcification]] is uncommon or even rare.
**[[Calcification]] is uncommon or even rare.<ref name="pmid1260697">{{cite journal |vauthors=Petito CK, DeGirolami U, Earle KM |title=Craniopharyngiomas: a clinical and pathological review |journal=Cancer |volume=37 |issue=4 |pages=1944–52 |date=April 1976 |pmid=1260697 |doi= |url=}}</ref>
**They are less locally aggressive.
**They are less locally aggressive.
**It has lower rate of recurrence.
**It has lower rate of recurrence.
**BRAF V600E [[mutation]]s are observed in [[papillary]] craniopharyngiomas.
**BRAF V600E [[mutation]]s are observed in [[papillary]] craniopharyngiomas.
*'''Mixed'''
*'''Mixed'''
**15%, but shares imaging features and prognosis similar to adamantinomatous.
**15%, but shares imaging features and prognosis similar to adamantinomatous.<ref name="pmid15569047">{{cite journal |author=Sekine S, Takata T, Shibata T, ''et al'' |title=Expression of enamel proteins and LEF1 in adamantinomatous craniopharyngioma: evidence for its odontogenic epithelial differentiation |journal=Histopathology |volume=45 |issue=6 |pages=573–9 |year=2004 |month=December |pmid=15569047 |doi=10.1111/j.1365-2559.2004.02029.x |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0309-0167&date=2004&volume=45&issue=6&spage=573}}</ref>


==References==
==References==

Revision as of 00:29, 15 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

There are two subtypes of craniopharyngioma based on the histological and imaging features: Adamantinomatous and papillary.

Classification

  • Craniopharyngiomas are classified according to their histologic appearance.
  • The histological appearances of the two pathological subtypes are different, accounting for the different imaging features.
  • The sub types are said to differ not only in appearances, but also in prognosis and epidemiology.[2]


  • Adamantinomatous
Microscopic pathology of Adamantinomatous craniopharyngioma.jpegSource:Wikimedia Commons
    • This type is seen predominantly in children.[1]
    • It consists of reticular epithelial cells which have appearances reminiscent of the enamel pulp of developing teeth.
    • There may be single or multiple cysts filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".[3]
    • "Wet keratin nodules" are a characteristic histological feature.[4]
    • Calcification is usually present in 90%
    • They are more locally aggressive.
    • It has higher rate of recurrence.
    • Activating beta-catenin gene mutations are found in adamantinomatous tumors.[5]


  • Papillary
Microscopic pathology of Papillary Craniopharyngioma Source:Wikimedia Commons
    • "Wet keratin" nodule is absent.[6]
    • Cysts do form, but these are less of a feature, and the tumor is more solid.[3]
    • Calcification is uncommon or even rare.[4]
    • They are less locally aggressive.
    • It has lower rate of recurrence.
    • BRAF V600E mutations are observed in papillary craniopharyngiomas.
  • Mixed
    • 15%, but shares imaging features and prognosis similar to adamantinomatous.[7]

References

  1. ↑ 1.0 1.1 1.2 Mortini P (August 2017). "Craniopharyngiomas: a life-changing tumor". Endocrine. 57 (2): 191–192. doi:10.1007/s12020-016-1192-2. PMID 27981519.
  2. ↑ Classification of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc
  3. ↑ 3.0 3.1 Müller HL (April 2017). "Risk-adapted, long-term management in childhood-onset craniopharyngioma". Pituitary. 20 (2): 267–281. doi:10.1007/s11102-016-0751-0. PMID 27604996.
  4. ↑ 4.0 4.1 4.2 Petito CK, DeGirolami U, Earle KM (April 1976). "Craniopharyngiomas: a clinical and pathological review". Cancer. 37 (4): 1944–52. PMID 1260697.
  5. ↑ Duff J, Meyer FB, Ilstrup DM, Laws ER, Schleck CD, Scheithauer BW (February 2000). "Long-term outcomes for surgically resected craniopharyngiomas". Neurosurgery. 46 (2): 291–302, discussion 302–5. PMID 10690718.
  6. ↑ Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (October 1998). "The descriptive epidemiology of craniopharyngioma". J. Neurosurg. 89 (4): 547–51. doi:10.3171/jns.1998.89.4.0547. PMID 9761047.
  7. ↑ Sekine S, Takata T, Shibata T; et al. (2004). "Expression of enamel proteins and LEF1 in adamantinomatous craniopharyngioma: evidence for its odontogenic epithelial differentiation". Histopathology. 45 (6): 573–9. doi:10.1111/j.1365-2559.2004.02029.x. PMID 15569047. Unknown parameter |month= ignored (help)


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