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Craniopharyngioma, a benign brain tumor, makes up 3 to 4 percent of intracranial tumors, with 60 percent of them occurring in adults. Craniopharyngiomas form in an area of the brain near the optic nerves and pituitary gland called the supraseller area, though 5 to 10 percent of tumors develop entirely in the third ventricle, an area of the brain that contains cerebrospinal fluid.
Patients with a craniopharyngioma may have headaches, vision changes or endocrine problems. Vision changes that may occur include a loss of peripheral vision or blindness in one or both eyes if the tumor grows. These vision problems may occur due to increased intracranial pressure or optic pathway compression. Female patients may have amenorrhea, while male patients may have impotence and a loss of libido. Other possible symptoms include hypothyroidism and adrenal failure.
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Behavioral Problems of Adult Craniopharyngioma Patients
In their study of 122 craniopharyngioma patients who had undergone surgery, van Effenterre and Boch note that behavioral problems did occur in children. In two cases noted, one patient developed a drug addiction and psychological issues after three surgeries and radiotherapy, while another patient developed anorexia after surgery. But what about the behavioral problems of adult craniopharyngioma patients? They do not appear to be as prevalent as in child craniopharyngioma patients. Some patients may become apathetic, display emotional immaturity or have psychomotor impairment or short-term memory problems. Behavioral problems may result from endocrine changes. For example, patients may develop an abnormally increased appetite and obesity, with obesity affecting 11 to 18 percent of patients.
One issue that does arise in adult craniopharyngioma patients is quality of life. In their study of 29 adult craniopharyngioma patients in remission, Dekkers et al. noted that patients had a lower quality of life, with visual problems that arise from a craniopharyngioma playing a large role. The authors added that patients may also experience deficits in behavior.
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The main treatments for a craniopharyngioma include surgery and radiation, with several methods for each; chemotherapy has not been shown to be effective with this type of brain tumor. In a study done on children, damage to the hypothalamus may have resulted in the personality changes, memory problems, weight gain and social interaction issues, with the radiation treatment possibly causing that hypothalamus damage. Patients who develop behavioral issues due to the craniopharyngioma may benefit from therapy that has a behavioral focus.
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van Effenterre, R., & Boch, A. (2010). Craniopharyngioma. In Tonn, J., Westphal, M., & Rutk, J.T (Ed.), Oncology of CNS Tumors (pp.559-570). Spring-Verlag Berlin Heidelberg
van Effenterre, R., & Boch. A. (2002). Craniopharyngioma in adults and children: a study of 122 surgical cases. Journal of Neurosurgery, 97(1), 3-11
Dekkers, O.M., Biermasz, N.R., Smit, J.W.A., Groot, L.E., Roelfsema, F., Romijn, J.A, & Pereira, A.M. (2006). Quality of life in treated adult craniopharyngioma patients. European Journal of Endocrinology, 154(3), 483-489
Dolson, E.D., Conklin, H.M, Chenghong, L., Xiong, X., & Merchant, T.E. (2010). Predicting behavioral problems in craniopharyngioma survivors after conformal radiation therapy. Pediatric Blood & Cancer, 52(7), 860-864
eMedicine Neurology: Craniopharyngioma
University of Florida, Department of Neurosurgery: Craniopharyngioma