Minimally Invasive Management of Adamantinomatous Intraventricular Craniopharyngiomas: A Two-Case Series

TL;DR

This paper presents two cases of rare brain tumors treated with minimally invasive surgery and radiation, showing good outcomes and minimal side effects.

Contribution

The study contributes two rare cases of adamantinomatous intraventricular craniopharyngiomas managed with a minimally invasive approach.

Findings

Endoscopic surgery combined with radiosurgery led to favorable outcomes in both patients.

Follow-up imaging showed no radiological progression of residual tumors after 24 and 30 months.

Symptoms improved, and key functions like vision and cognition were preserved.

Abstract

Intraventricular craniopharyngiomas (IVCPs) are rare intracranial tumors that pose significant therapeutic challenges due to their deep-seated location, close relationship with critical neurovascular structures, and high risk of treatment-related morbidity. We report two adult cases of adamantinomatous intraventricular craniopharyngiomas, a histological subtype that is uncommon among intraventricular lesions, managed at the Neurosurgery Department of Mohammed VI University Hospital in Casablanca, Morocco. Both patients underwent endoscopic transventricular tumor resection followed by adjuvant Gamma Knife radiosurgery for residual tumor components. Postoperative outcomes were favorable, with improvement of presenting symptoms and preservation of visual, endocrine, and cognitive functions, allowing return to professional activities. After a follow-up period of 24 months in Case 1 and 30 months in Case 2, follow-up imaging demonstrated stable residual lesions without radiological progression. These cases suggest that a minimally invasive strategy combining endoscopic surgery and stereotactic radiosurgery may provide effective tumor control while minimizing neurological and endocrine morbidity in selected patients with intraventricular craniopharyngiomas and are discussed in light of current literature regarding their epidemiology, clinical presentation, radiological features, therapeutic strategies, and prognosis.

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