Management of a historical giant craniopharyngioma in a child: Technical note

Introduction

Craniopharyngioma are rare histologically benign epithelial tumor originating from the pituitary stalk or the hypophysis. We report here the case of an 8-year-old girl treated for a giant craniopharyngioma revealed by neuropsychiatric disorders.

Clinical observation

An 8-year-old girl, 2nd in a family of 5, with no medical history, was admitted to our department for 6 months story of progressive behavioral disorders complicated by headaches with few episodes of vomiting taken as malaria’ s symptoms. Her clinical examination found a jovial girl, hyperactive, humorous with a Glasgow Coma Scale of 15, sub-stiff neck without sensorimotor deficit. The ophthalmological examination found a blind child in both eyes with bilateral papillary pallor. Brain CT scan revealed a large extra-axial, intra and suprasellar bilocular cystic process, with obvious bifrontal development and presenting fine circumferential parietal calcifications and measuring 156 mm × 101 mm × 152 mm in its large diameters. Under general anesthesia and in supine position, this cyst was punctured by subtraction of 230 cc of “engine oil-like” liquid through the Cushing trocar followed by the placement of an Ommaya reservoir. The postoperative course was simple and the control CT scan was satisfactory.

Conclusion

Craniopharyngioma is a benign but serious tumor, especially in children. The treatment of choice remains surgery, which is incomplete in the majority of cases.