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Craniopharyngioma in pediatrics: diagnosis and treatment

Craneofaringioma en pediatría : diagnóstico y tratamiento.




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Craniopharyngioma in pediatrics: diagnosis and treatment.
Rev. colomb. hematol. oncol. [Internet]. 2020 Aug. 1 [cited 2025 Jan. 15];7(2):64-7. Disponible en: https://doi.org/10.51643/22562915.112

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Edgar Cabrera Bernal,

MD., Esp. Onco-hematología pediatrica.


Craniopharyngiomas (CP) are rare tumors of low histological malignancy that arise along the craniopharyngeal duct. The two histological subtypes, adamantinomatous craniopharyngioma (ACP) and papillary (PCP), differ in origin and distribution by age. ACPs are diagnosed with a bimodal incidence peak (5–15 years and 45–60 years), while PCPs occur exclusively in adults, mainly in the fifth and sixth decades of life. ACPs are generated by somatic mutations in CTNNB1, encoder of β-catenin and are predominantly cystic in appearance. PCPs have somatic mutations in BRAF V600E and are typically solid tumors. The clinical manifestations of endocranial hypertension, visual compromise or endocrine deficiencies should alert us to request images. The treatment generally includes neurosurgery and radiotherapy (RT); Intracystic chemotherapy is used in monocystic ACP. Although long-term survival is high, quality of life and neuropsychological function are frequently affected, due to the anatomical proximity to the optic chiasma, the hypothalamus and the pituitary gland. Hypothalamic involvement by the tumor and injuries secondary to treatment often result in hypothalamic obesity and neuropsicosocial deficits.


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  1. Buslei R, Rushing EJ, et al. Craniopharyngioma. En: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO Classification of Tumours of the Central Nervous System. Revised 4th ed. France: International Agency for Research on Cancer; 2016. 328 p.
  2. Müller HL, Merchant TE, Warmuth-Metz M, Martinez-Barbera JP, Puget S. Craniopharyngioma. Nat Rev Dis Primers [Internet]. 2019;5:75 https://doi.org/10.1038/s41572-019-0133-9
  3. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner M. The descriptive epidemiology of craniopharyngioma. J. Neurosurg [Internet]. 1998; 89:547–551. https://doi.org/10.3171/jns.1998.89.4.0547
  4. Olsson DS, Andersson E, Bryngelsson IL, Nilsson AG, Johannsson G. Excess mortality and morbidity in patients with craniopharyngioma, especially in patients with childhood onset: a population- based study in Sweden. J. Clin. Endocrinol. Metab [Internet]. 2015;100:467–474. https://doi.org/10.1210/jc.2014-3525
  5. Zacharia BE, Bruce SS, Goldstein H, Malone HR, Neugut AI, Bruce J. Incidence, treatment and survival of patients with craniopharyngioma in the Surveillance, Epidemiology and End Results program. Neuro Oncol [Internet]. 2012;14:1070–1078. https://doi.org/10.1093/neuonc/nos142
  6. Makino K, Nakamura H, Yano S, Kuratsu J, Kumamoto Brain Tumor Group. Population- based epidemiological study of primary intracranial tumors in childhood. Childs Nerv. Syst [Internet]. 2010;26:1029–1034. https://doi.org/10.1007/s00381-010-1126-x
  7. Rosemberg S, Fujiwara D. Epidemiology of pediatric tumors of the nervous system according to the WHO 2000 classification: a report of 1,195 cases from a single institution. Childs Nerv. Syst [Internet]. 2005;21:940–944. https://doi.org/10.1007/s00381-005-1181-x
  8. Nielsen EH, Feldt-Rasmussen U, Poulsgaard L, Kristensen LO, Astrup J, Jørgensen JO, et al. Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults. J. Neurooncol [Internet]. 2011;104:755–763. https://doi.org/10.1007/s11060-011-0540-6
  9. Larkin SJ, Ansorge O. Pathology and pathogenesis of craniopharyngiomas. Pituitary [Internet]. 2013;16:9-17. https://doi.org/10.1007/s11102-012-0418-4
  10. Muller-Scholden J, Lehrnbecher T, Müller HL, Bensch J, Hengen RH, Sörensen N, et al. Radical surgery in a neonate with craniopharyngioma. Report of a case. Pediatr. Neurosurg [Internet]. 2000;33:265–269. https://doi.org/10.1159/000055967
  11. Bailey W, Freidenberg GR, James HE, Hesselink JR, Jones KL. Prenatal diagnosis of a craniopharyngioma using ultrasonography and magnetic resonance imaging. Prenat. Diagn [Internet]. 1990;10:623–629. https://doi.org/10.1002/pd.1970101002
  12. Chentli F, Belhimer F, Kessaci F, Mansouri, B. Congenital craniopharyngioma: a case report and literature review. J. Pediatr. Endocrinol. Metab [Internet]. 2012; 25:1181–1183. https://doi.org/10.1515/jpem-2012-0251
  13. Crotty TB, Scheithauer BW, Young WF, Davis DH, Shaw EG, Miller GM, et al. Papillary craniopharyngioma: a clinicopathological study of 48 cases. J. Neurosurg [Internet]. 1995;83:206–214. https://doi.org/10.3171/jns.1995.83.2.0206
  14. Karavitaki N, Wass J. Craniopharyngiomas. Endocrinol Metab Clin N Am [Internet]. 2008;37:173–193. https://doi.org/10.1016/j.ecl.2007.10.012
  15. Garnett MR, Puget S, Grill J, Sainte- Rose C. Craniopharyngioma. Orphanet Journal of Rare Diseases [Internet]. 2007;2:18. https://doi.org/10.1186/1750-1172-2-18
  16. Boch AL, van Effenterre, R, Kujas M. Craniopharyngiomas in two consanguineous siblings: case report. Neurosurgery [Internet]. 1997;41:1185–1187. https://doi.org/10.1097/00006123-199711000-00031
  17. Green AL, Yeh JS, Dias PS. Craniopharyngioma in a mother and daughter. Acta Neurochir [Internet]. 2002;144:403–404. https://doi.org/10.1007/s007010200058
  18. Pereira AM, Schmid EM, Schutte PJ, Voormolen JH, Biermasz NR, van Thiel SW, et al. High prevalence of long- term cardiovascular, neurological and psychosocial morbidity after treatment for craniopharyngioma. Clin. Endocrinol [Internet]. 2005;62:197–204. https://doi.org/10.1111/j.1365-2265.2004.02196.x
  19. Muller HL, Bueb K, Bartels U, Roth C, Harz K, Graf N, et al. Obesity after childhood craniopharyngioma - German multicenter study on pre- operative risk factors and quality of life. Klin. Padiatr [Internet]. 2001;13:244–249. https://doi.org/10.1055/s-2001-16855
  20. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E. Outcome of craniopharyngioma in children: long- term complications and quality of life. Dev. Med. Child Neurol [Internet]. 2004;46:220–229. https://doi.org/10.1017/s0012162204000374
  21. Visser J, Hukin J, Sargent M, Steinbok P, Goddard K, Fryer C. Late mortality in pediatric patients with craniopharyngioma. J. Neurooncol [Internet]. 2010; 100:105–111 (2010). https://doi.org/10.1007/s11060-010-0145-5
  22. Hoffmann, A. et al. Fusiform dilatation of the internal carotid artery in childhood- onset craniopharyngioma: multicenter study on incidence and long- term outcome. Pituitary [Internet]. 2016;19,422–428.
  23. Wijnen M, Olsson DS, van der Heuvel-Eibrink MM, Hammarstrand C, Lanssen J, et al. Excess morbidity and mortality in patients with craniopharyngioma: a hospital- based retrospective cohort study. Eur. J. Endocrinol [Internet]. 2018; 178:93–102. https://doi.org/10.1530/eje-17-0707
  24. Wijnen M, Olsson DS, van der Heuvel-Eibrink MM, Hammarstrand C, Lanssen J, et al. The metabolic syndrome and its components in 178 patients treated for craniopharyngioma after 16 years of follow- up. Eur. J. Endocrinol [Internet]. 2018;178:11–22. https://doi.org/10.1530/eje-17-0387
  25. Wijnen M, van der Heuvel-Eibrink MM, Lanssen J, Castman-Berrevoets CE, Michiels EM, et al. Very long- term sequelae of craniopharyngioma. Eur. J. Endocrinol [Internet]. 2017;176:755–767. https://doi.org/10.1530/eje-17-0044
  26. Holmer H, Popovic V, Ekman B, Follin C, Siversson AB, Esfurth EM. Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma. Eur. J. Endocrinol [Internet]. 2011;165:25–31. https://doi.org/10.1530/eje-11-0229
  27. Hoffmann A, Bootsveld K, Gebhardt Um Daubenbüchel AM, Sterkenburg AS, Müller HL. Nonalcoholic fatty liver disease and fatigue in long- term survivors of childhood- onset craniopharyngioma. Eur. J. Endocrinol [Internet]. 2015; 173:389–397. https://doi.org/10.1530/eje-15-0422
  28. Heinks K, De Schutter-Nüsse C, Boekhoff S, Bogusz A, Zhu J, Peng J, et al. Periostin concentrations in childhoodonset craniopharyngioma patients. J. Endocrinol. Invest [Internet]. 2019;42:815–824. https://doi.org/10.1007/s40618-018-0987-9
  29. Erfurth EM, Holmer H, Fjalldal SB. Mortality and morbidity in adult craniopharyngioma. Pituitary [Internet] 2013;16:46–55. https://doi.org/10.1007/s11102-012-0428-2
  30. Sekine S, Shibata T, Kokubu A, Morishita Y, Noguchi M, Nakanishi Y, et al. Craniopharyngiomas of adamantinomatous type harbor beta- catenin gene mutations. Am. J. Pathol [Internet]. 2002;161:1997–2001. https://doi.org/10.1016/s0002-9440(10)64477-x
  31. Buslei R, Nolde M, Hofmann B, Meissner S, Eyupoglu IY, Siebzehnrübl F, et al. Common mutations of β- catenin in adamantinomatous craniopharyngiomas but not in other tumours originating from the sellar region. Acta Neuropathol [Internet]. 2005;109:589–97. https://doi.org/10.1007/s00401-005-1004-x
  32. Brastianos PK, Taylor-Weiner A, Manley PE, Jones RT, Dias-Santagata D, Thorner AR, et al. Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat. Genet [Internet]. 2014;46:161–165. https://doi.org/10.1038/ng.2868
  33. Hölsken A, Buchfelder M, Fahlbusch, Blümcke I, Buslei R. Tumour cell migration in adamantinomatous craniopharyngiomas is promoted by activated Wnt-signalling. Acta Neuropathol [Internet]. 2010;119:631–639. https://doi.org/10.1007/s00401-010-0642-9
  34. Gaston-Massuet C, Andoniadoua CL, Signore M, Jayakodya SA, Charolidi N, Kyeyune R, et al. Increased Wingless (Wnt) signaling in pituitary progenitor/stem cells gives rise to pituitary tumors in mice and humans. Proc Natl Acad Sci USA [Internet]. 2011; 108(28):11282-7. https://doi.org/10.1073/pnas.1101553108
  35. Apps JR, Carreño G, González-Meljem JM, Haston S, Guiho R, Cooper JE, et al. Tumour compartment transcriptomics demonstrates the activation of inflammatory and odontogenic programmes in human adamantinomatous craniopharyngioma and identifies the MAPK/ERK pathway as a novel therapeutic target. Acta Neuropathol [Internet]. 2018;135(5):757–777. https://doi.org/10.1007/s00401-018-1830-2
  36. Andoniadou CL, Gaston-Massuet C, Reddy R, Schneider RP, Blasco MA, Le Tissier P, et al. Identification of novel pathways involved in the pathogenesis of human adamantinomatous craniopharyngioma. Acta Neuropathol [Internet]. 2012;124(2):259–271. https://doi.org/10.1007/s00401-012-0957-9
  37. Carreno G, Boult JKR, Apps J, González-Meljem JM, Haston S, Guiho R, Stache C, et al. SHH pathway inhibition is protumourigenic in adamantinomatous craniopharyngioma. Endocr. Relat. Cancer [Internet]. 2019;26(3):355–366. https://doi.org/10.1530/erc-18-0538
  38. Goschzik, T, Gwaae M, Dreschmann V, Gebhardt U, Wang L, Yamaguchi S, et al. Genomic alterations of adamantinomatous and papillary craniopharyngioma. J. Neuropathol. Exp. Neurol [Internet]. 2017;76(2):126–134. https://doi.org/10.1093/jnen/nlw116
  39. Holsken A, Sill M, Merkle J, Schweizer L, Buchfelder M, Flitsch J, et al. Adamantinomatous and papillary craniopharyngiomas are characterized by distinct epigenomic as well as mutational and transcriptomic profiles. Acta neuropathol Commun [Internet]. 2016;4:20. https://doi.org/10.1186/s40478-016-0287-6
  40. Haston S, Pozzi S, Carreno G, Manshaer S, Paousopoloulos L, González-Meljem JM, et al. MAPK pathway control of stem cell proliferation and differentiation in the embryonic pituitary provides insights into the pathogenesis of papillary craniopharyngioma. Development [Internet]. 2017;144(12):2141–2152. https://doi.org/10.1242/dev.150490
  41. Müller HL, Emser A, Faldum A, Bruhnken G, Etavard-Gorris N, Gebhardt U, et al. Longitudinal study on growth and body mass index before and after diagnosis of childhood craniopharyngioma. J. Clin. Endocrinol. Metab [Internet]. 2004; 89(7):3298–3305. https://doi.org/10.1210/jc.2003-031751
  42. Hoffmann A, Boekhoff S, Gebhardt U, Sterkenburg AS, Daubenbüchek AMM, Eveslage M, et al. History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis. Eur J Endocrinol [Internet]. 2015;173(6):853-862. https://doi.org/10.1530/eje-15-0709
  43. Prieto R, Pascual JM, Barrios L. Optic chiasm distortions caused by craniopharyngiomas: clinical and magnetic resonance imaging correlation and influence on visual outcome. World Neurosurg [Internet]. 2015;83(4):500–529. https://doi.org/10.1016/j.wneu.2014.10.002
  44. Müller HL. Childhood Craniopharyngioma. Horm Res [Internet]. 2008;69:193–202. https://doi.org/10.1159/000113019
  45. Zhou L, Luo L, Xu J, Chen J, Jiang S, Cai B, et al. Craniopharyngiomas in the posterior fossa: a rare subgroup, diagnosis, management and outcomes. J Neurol Neurosurg Psychiatry [Internet]. 2009;80(10):1150-1155. https://doi.org/10.1136/jnnp.2008.149088
  46. Elliott RE, Jane JAJr, Wisoff JH. Surgical management of craniopharyngiomas in children: meta- analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery [Internet]. 2011;69(3):630–643. https://doi.org/10.1227/neu.0b013e31821a872d
  47. Muller, H. L. Childhood craniopharyngioma. Recent advances in diagnosis, treatment and follow- up. Horm. Res [Internet]. 2008;69(4):193–202. https://doi.org/10.1159/000113019
  48. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI. Aggressive surgical management of craniopharyngiomas in children. J. Neurosurg [Internet]. 1992;76(1):47–52. https://doi.org/10.3171/jns.1992.76.1.0047
  49. Roth CL, Gebhardt U, Müller HL. Appetite-regulating hormone changes in patients with craniopharyngioma. Obesity [Internet]. 2011;19(1):36–42. https://doi.org/10.1038/oby.2010.80
  50. Kilday JP, Bartels U, Huang A, Barron M, Shago M, Mistry M, et al. Favorable survival and metabolic outcome for children with diencephalic syndrome using a radiation- sparing approach. J. Neurooncol [Internet]. 2014; 116(1):195–204. https://doi.org/10.1007/s11060-013-1284-2
  51. Hoffmann A, Gebhardt U, Sterkenburg AS, Warmuth- Metz M, Müller HL. Diencephalic syndrome in childhood craniopharyngioma- results of german multicenter studies on 485 long- term survivors of childhood craniopharyngioma. J. Clin. Endocrinol. Metab [Internet]. 2014;99(11):3972–3977. https://doi.org/10.1210/jc.2014-1680
  52. Rossi A, Cama A, Consales A, Gandolfo C, Garrè ML, Milanaccio C, et al. Neuroimaging of pediatric craniopharyngiomas: a pictorial essay. J. Pediatr. Endocrinol. Metab. 2006; 19(Suppl 1):299–319. PMID: 16700305
  53. Hoffmann A, Brentrup A, Muller HL. First report on spinal metastasis in childhood- onset craniopharyngioma. J. Neurooncol [Internet]. 2016;129(1):193–194. https://doi.org/10.1007/s11060-016-2160-7
  54. Kordes U, Flitsch CH, Goebell E, Rchwarz R, Herberhold A, von Bueren AO, et al. Ectopic craniopharyngioma. Klin. Padiatr [Internet]. 2011;223(3):176–177. https://doi.org/10.1055/s-0031-1273743
  55. Warmuth-Metz M, Gnekow AK, Muller H, Solymosi L. Differential diagnosis of suprasellar tumors in children. Klin Padiatr [Internet]. 2004;216(6):323-330. https://doi.org/10.1055/s-2004-832358
  56. Prieto R, Pascual JM, Hofecker V, Winter E, Castro-Dufourny I, Carrasco R, et al. Craniopharyngioma adherence: a reappraisal of the evidence. Neurosurg. Rev [Internet]. 2018;43:453-472. https://doi.org/10.1007/s10143-018-1010-9.
  57. Hill TK, Baine MJ, Verma V, Alam M, Lyden ER, Lin C, et al. Patterns of care in pediatric craniopharyngioma: outcomes following definitive radiotherapy. Anticancer Res [Internet]. 2019;39(2):803–807. https://doi.org/10.21873/anticanres.13178
  58. Cavalheiro S, Di Rocco C, Valenzuela S, Dastoli PA, Tamburrini G, Massimi L, et al. Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus [Internet]. 2010; 28(4):E12. https://doi.org/10.3171/2010.1.focus09310
  59. Kilday JP, Caldarelli M, Massimi L, Chen RH, Lee YY, Liang M, et al. Intracystic interferon-alpha in pediatric 434 craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and 435 ISPN. Neuro Oncol [Internet]. 2017;19(10):1398-1407. https://doi.org/10.1093/neuonc/nox056
  60. Zhang S, Fang Y, Cai BW, Xu JG, You C. Intracystic bleomycin for cystic craniopharyngiomas in children. Cochrane Database Syst [Internet]. 2016; 7(7):CD008890. https://doi.org/10.1002/14651858.cd008890.pub4
  61. Adeberg S, Harrabi SB, Bougatf N, Verma V, Windisch P, Bernhardt D, et al. Dosimetric Comparison of Proton Radiation Therapy, Volumetric Modulated Arc Therapy, and Three-Dimensional Conformal Radiotherapy Based on Intracranial Tumor Location. Cancers [Internet]. 2018;10(11):401. https://doi.org/10.3390/cancers10110401
  62. Müller HL. Hypothalamic involvement in craniopharyngioma — implications for surgical, radiooncological, and molecularly targeted treatment strategies. Pediatr. Blood. Cancer [Internet]. 2018;65(5):e26936. https://doi.org/10.1002/pbc.26936
  63. Merchant TE, Hua C-H, Sabin ND, Wu S, Khan RB, Indelicato, et al. Necrosis, vasculopathy, and neurological complications after proton therapy for childhood craniopharyngioma: Results from a prospective trial and a photon cohort comparison. Int J Rad Biol Oncol Phys [Internet]. 2016;96(2):S12- S121. https://doi.org/10.1016/j.ijrobp.2016.06.294
  64. Merchant T, Indelicato D, Hua C, Wu S, Conklin 430 H. Comparison of academic scores after proton and photon therapy in children and young adults with craniopharyngioma. Pediatr Blood Cancer [Internet]. 2017;64:e2677.
  65. Muller HL, Gebhardt U, Faldum A, Warmuth-Metz M, Pietsch T, Pohl F, et al. Xanthogranuloma, Rathke's cyst, and childhood craniopharyngioma: results of prospective multinational studies of children and adolescents with rare sellar malformations. J. Clin. Endocrinol. Metab [Internet]. 2012;97(11):3935–3943. https://doi.org/10.1210/jc.2012-2069
  66. Muller HL, Gebhardt U, Teske C, Faldum A, Zwiener I, Warmuth-Metz M, et al. Post- operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow- up. Eur. J. Endocrinol [Internet]. 2011;165(1):17–24. https://doi.org/10.1530/eje-11-0158
  67. Hankinson TC, Palmeri NO, Williams SA, Torok MR, Serramo CA, Foreman NK, et al. Patterns of care for craniopharyngioma: survey of members of the American Association of Neurological Surgeons. Pediatr. Neurosurg [Internet]. 2013; 49(3):131–136. https://doi.org/10.1159/000357783
  68. Schwartz TH. A role for centers of excellence in transsphenoidal surgery. World Neurosurg [Internet]. 2013;80(3):270–271. https://doi.org/10.1016/j.wneu.2012.11.019
  69. Tallen G, Resch A, Calaminus G, Wiener A, Leiss U, Pletschko T, et al. Strategies to improve the quality of survival for childhood brain tumour survivors. Eur. J. Paediatr. Neurol [Internet]. 2015;19(6):619–639. https://doi.org/10.1016/j.ejpn.2015.07.011
  70. Müller HL, Reichel J, Boekhoff S, Warmuth-Metz M, Eveslage M, Peng J, et al. Low concordance between surgical and radiological assessment of degree of resection and treatment- related hypothalamic damage: results of KRANIOPHARYNGEOM 2007. Pituitary [Internet]. 2018;21(4),371–378. https://doi.org/10.1007/s11102-018-0883-5
  71. Gump JM, Donson AM, Birks DK, Amani VM, Rao KK,Griesinger AM, et al. Identification of targets for rational pharmacological therapy in childhood craniopharyngioma. Acta Neuropathol. Commun [Internet]. 2015;3:30. https://doi.org/10.1186/s40478-015-0211-5
  72. Rimkus TK, Carpenter RL, Qasem S, Chan M, Lo HW. Targeting the sonic hedgehog signaling pathway: review of Smoothened and GLI inhibitors. Cancers [Internet]. 2016;8(2):E22. https://doi.org/10.3390/cancers8020022
  73. Sekulic A, Migden MR, Basset-Seguin N, Garbe C, Geiesrich A, Lao CD, et al. Long- term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer [Internet]. 2017;17(1):332. https://doi.org/10.1186/s12885-017-3286-5
  74. Miller C, Guillaume D, Dusenbery K, Clark HB, Moertel C. Report of effective trametinib therapy in 2 children with progressive hypothalamic optic pathway pilocytic astrocytoma: documentation of volumetric response. J. Neurosurg. Pediatr [Internet]. 2017;19(3):319–324. https://doi.org/10.3171/2016.9.peds16328
  75. Robert C, Flaherty KT, Hersey P, Nathan PD, Garbe C, Milhem MM, et al. METRIC phase III study: efficacy of trametinib (T), a potent and selective mek inhibitor (MEKi), in progression- free survival (PFS) and overall survival (OS), compared with chemotherapy (C) in patients (pts) with BRAFV600/k mutant advanced or metastatic melanoma (MM). J. Clin. Oncol [Internet]. 2012;30(18 Suppl) LBA8509. https://doi.org/10.1200/jco.2012.30.18_suppl.lba8509
  76. Grob S, Mirsky DM, Donson AM, Dahl N, Foreman NK, Hoffman LM, et al. Targeting IL-6 is a potential treatment for primary cystic craniopharyngioma. Front. Oncol [Internet]. 2019;9:791. https://dx.doi.org/10.3389%2Ffonc.2019.00791
  77. Ismail D, O'Connell MA, Zacharin MR. Dexamphetamine use for management of obesity and hypersomnolence following hypothalamic injury. J. Pediatr. Endocrinol. Metab [Internet]. 2006;19(2):129–134. https://doi.org/10.1515/jpem.2006.19.2.129
  78. Eveslage M, Calaminus G, Warmuth-Metz M, Kortmann R, Pohl F, Timmermann B, et al. The postoperative quality of life in children and adolescents with craniopharyngioma. Dtsch Arztebl. Int [Internet]. 2019;116(18);321–328. https://dx.doi.org/10.3238%2Farztebl.2019.0321
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