Consensus guidelines for the management of craniopharyngioma in low- and middle-income countries

Abstract

Craniopharyngiomas are benign, extra-axial epithelial
tumours originating from the pituitary stalk, impacting
areas such as the hypothalamus, optic chiasm, and
various cranial nerves. These tumours present unique
surgical challenges due to their proximity to critical
neurovascular structures. Management typically involves
maximal safe resection as the primary approach.
However, in low- and middle-income countries (LMICs),
factors like late presentation, higher risks of endocrine
and visual complications, frequent recurrence, and
potential for incomplete resection complicate treatment.
These challenges are exacerbated by limited access to
specialised expertise and surgical equipment, increasing
the risk of damage during surgery compared to High-
Income Countries. This manuscript outlines management
guidelines tailored for LMICs, emphasizing that a
combination of surgical resection and chemoradiation
therapy, as advised by a neuro-oncology tumour board,
often yields the best outcomes.
Keywords: Craniopharyngioma, optic chiasm, pituitary
gland, hypothalamus, neoplasms, glandular, epithelial