Craniopharyngiomas constitute 2 to 4% of intracranial neoplasms. Although this tumors exhibit a benign histopathological pattern, recurrence is commonly reported by cerebrospinal fluid seeding and direct brain invasion. The aim of this study was to analyses and recognizes craniopharyngioma pathological features in relationship to brain invasion as a prognostic factor.
One hundred patients who were surgically treated for Craniopharyngiomas extending outside the sellar and suprasellar regions were evaluated. Clinical, pathological and immunohistochemistry profile correlations were done.
The age of the patients varied from 15 to 87 years (mean 49.4 yrs); 41 (41%) patients were males and 59 (59%) were females. Brain invasion was found in 51 cases, recurrence occurred in 45 patients and 11 died. The follow-up was for 30.12 ± 13.82 months. The arrange mean of KI67-Li in tumoral nest cell invasion was 32.04 ± 6.57 vs. 16.68 ± 4.0 for non tumoral invasion (p = 0.000). The intratumoral MVD-Li (CD34) mean range in invasive tumors was 4.84 ± 1.06 vs. 4.88 ± 1.01 in non-invasive tumors (p = 0.462). The amount of MVD-li in peritumoral area was 17.98 ± 4.67 vs. 14.84 ± 5.16 of non peritumoral (p = 0.017). Higher Ki67-Li in neoplastic nest cells, were correlated with higher peritumoral MVD-Li (p = 0.033), and E-Cadherin, β-tubulin, NFG and D2DR intratumoral positive immnunoexpression.
Invasion in craniopharyngioma is a common event that it is associated, to neuronal differentiation in tumoral cells and hypoxic chances. The neoplastic nest cells in the adjacent brain tissue showed a higher labelling index, higher peritumoral microvascular density, but not always it was associated to recurrence.