Craniofaringioma e manejo do pan-hipopituitarismo: Um relato de caso

Abstract

Craniopharyngiomas are rare benign tumors derived from remnants of Rathke's pouch, located in the suprasellar space. They represent 1 to 3% of all brain tumors, with two predominant incidence age groups: children (5-15 years) and adults (5th decade of life). The main subtypes are papillary and adamantinomatous, the latter being more common. They grow slowly and can invade locally, causing significant morbidity due to mass effect and endocrine complications such as hypopituitarism and hypothalamic obesity. The diagnosis is mainly based on imaging, usually magnetic resonance imaging, which reveals a suprasellar mass capable of compressing the optic chiasm. Symptoms include visual disturbances, headaches and hormonal deficits, especially in children. The case in question involved a 30-year-old man with progressive hemianopsia and headache. After MRI diagnosed a mass lesion measuring 20 x 10 x 10 mm, he underwent transsphenoidal approach for biopsy and subtotal resection, followed by adjuvant radiotherapy. Despite developing panhypopituitarism, treated with hormones and corticosteroids, the patient is asymptomatic after 5 years, with MRI control showing a remaining lesion measuring 5 x 4 x 6 mm. In short, craniopharyngiomas, despite being benign, present significant challenges due to their complex location and potential complications. Therapeutic management involves decisions between different surgical and radiotherapy approaches, with special attention to preserving quality of life, especially in young patients. Early diagnosis and a multidisciplinary approach are essential to optimize results and ensure adequate follow-up.