Treatment dilemma of craniopharyngioma and its molecular targeted therapy

Abstract

Craniopharyngioma is a benign tumor of WHO grade Ⅰ. As the location of craniopharyngioma is deep, around which the peripheral structure is complex, the tumor adheres closely to the pituitary stalk and hypothalamus, and a small number of craniopharyngioma have the growth characteristics of malignant tumor, the total resection of craniopharyngioma is hard to achieve. Radiotherapy is only effective in some patients and is often associated with complications such as radiation damage to the pituitary and optic nerve. So, the treatment of craniopharyngioma is still challenging for neurosurgeons and endocrinologists. With the development of molecular biology technology, some new findings are made ragarding the pathological classification of craniopharyngioma and its mechanism. The revised 4th edition of 2016 WHO classification of central nervous system tumors classifies craniopharyngioma into adamantinomatous and papillary craniopharyngioma. There are significant differences in clinical susceptibility, histopathological characteristics and genetic changes between two types. These differences not only help to clarify molecular pathological classification of craniopharyngioma, but also provide a theoretical basis for its molecular targeted therapy. However, more transformational studies and multicenter clinical trials are needed to develop more effective molecular targeted therapy drugs.DOI：10.3969/j.issn.1672⁃6731.2020.03.004