Craniopharyngioma – Childhood
Childhood craniopharyngiomas are rare and slow growing tumours found in the brain usually near the pituitary gland, which is a pea-sized organ at the bottom of the brain. Pituitary gland function is to control other glands and produce many different hormones which affects as to how the body functions. Pituitary gland is a part of the brain called suprasellar region. This is the area of the brain just above the sella and again above sella are located the optic nerves and a gland called the hypothalamus, which controls, body temperature, hunger sleep, thirst, fatigue and other behaviours. Hypothalamus is a small cone shaped organ which connects to the pituitary gland by nerves.
Craniopharyngioma tumour may be detected in a person after many years as it is a slow growing tumour. It can be solid and/or cystic. A cystic tumour mostly contains very high amounts of protein and the solid tumour contains areas of calcium.
Symptoms of craniopharyngioma are caused when the tumour presses on blood vessels or nerves as a result of which brain cannot function properly in those areas or when hormonal changes take place, or when pressure builds up in the brain. Unless the symptoms listed below are seen in the child craniopharyngioma is not diagnosed.
- Nausea and/or vomiting
- Difficulty with balance
- Increased sleepiness
- Mood changes
- Headaches, more severe in the morning
- Vision changes
- Increased urination
- Slow or halted growth
- Excessive weight gain
- Early or delayed puberty
- Excessive thirst
While choosing a diagnostic test these factors are considered namely the child’s symptoms, age and medical condition, type of tumour suspected and the results of the earlier medical tests.
Physical examination, blood tests, biopsy are done to diagnose the existence of craniopharyngioma tumour and, if required, Computed tomography (CT scan) or Magnetic resonance imaging (MRI) may be carried out.
Surgery is the most common treatment for craniopharyngioma. Surgery is done by a neurosurgeon, who specializes in removing brain tumours. Surgeons try to remove the tumour completely or as much as possible. Side effect of surgery depends on the location of the tumour.
Another option for treating craniopharyngioma is Radiation therapy, which is carried out by a Radiation oncologist using high-energy x-rays or other particles to destroy the tumour cells. At times a high dose of radiation therapy is given to the tumour, called radiosurgery. In this technique the doctor knows exactly the place where to deliver the radiation treatment. Radiosurgery is used mostly in cases of recurrent craniopharyngioma.
Palliative or supportive care is required for children treated with craniopharyngioma to deal with the short term side effects like mild skin reactions, nausea and fatigue and also permanent side effects like hair loss, weight gain, memory problems, low hormone levels and learning difficulties.