The initial symptoms of craniopharyngioma vary depending on the age of onset, tumor size, tumor growth direction and time of detection, mainly including headache, vision loss, visual field defects, growth retardation, polyhydramnios and endocrine disorders. With the popularization of medical imaging equipment, especially the application of CT and nuclear magnetic equipment, the diagnosis level of craniopharyngioma has been improved to a great extent. At present, surgery is still the main treatment, and some doctors in some hospitals think that radiation therapy is also effective, but I do not think that radiation therapy for craniopharyngioma is recommended. Most of the patients and their families do not really care what method doctors use to treat the disease. For patients, whether it is surgery, medicine, injection, or radiotherapy, as long as the disease can be treated, it is the best. Here I will explain a few issues that patients and their families are most concerned about, combined with more than 100 cases treated by our hospital in recent years. 1.Is craniopharyngioma a benign or malignant tumor? Answer: Craniopharyngioma is a benign tumor. 2.Will craniopharyngioma recur after surgery? Answer: This is a very complicated question, and it should be said from several aspects. First, craniopharyngioma itself is a benign tumor, and if the surgery is clean, in theory, the chance of recurrence is very low. But the problem lies in this “if”, and secondly, it is quite difficult to remove the tumor cleanly. To give you a straightforward example, we have eaten walnuts, right, take a complete walnut, walnut flesh is generally white, white flesh outside there is a very thin layer of brown or dark skin, generally we eat walnuts is even this layer of skin together. Now we need to peel off the brown or dark skin completely and not to destroy the walnut flesh; for example, there is a piece of tofu on the board, and now we need to carve a flower in the middle of the surface of the board and tofu without picking up the tofu. The flower must be carved beautifully and not damage the tofu. The anatomical structure of the saddle area of the brain is much more complicated than that of a walnut, and the envelope of the tumor is thinner than the walnut skin, and it may be transparent. This means that there is a layer of “502” or “buddy” between the walnut flesh and the membrane. If the tofu is broken, it can be replaced by another piece, but the brain tissue and nerves cannot be replaced. This is the reason why doctors sometimes prefer not to cut a tumor when they operate. Removing craniopharyngioma requires a very high level of surgical operation, and no doctor dares to guarantee the complete removal of craniopharyngioma before surgery. In our hospital, the rate of complete surgical resection has been very high in recent years, but still a small number of patients do have the problem of post-operative recurrence. 3.Does surgical treatment damage vision? Answer: Among patients with craniopharyngioma, some of them have initial symptoms of vision loss and visual field defects, which are mainly caused by the tumor growing forward and squeezing the optic nerve and optic cross. During the surgical treatment, the compression of the optic nerve will be lifted after the tumor is removed. In more than one hundred cases done in our hospital, the vision of most patients has been improved. However, if the course of the disease is long and the optic nerve has been compressed for a long time and has degenerated, the chance of vision recovery is very small; then there is the case of tumor wrapping around the optic nerve and the adhesion is heavy, doctors will mostly choose to remove some remaining tumor tissues on the surface of the nerve, but few people will choose to physically remove the optic nerve, so the vision of such patients will be affected to some extent after surgery. 4. Can the hormone level return to normal after surgery? Answer: The location of craniopharyngioma is mostly located in the pituitary stalk, and most of the lesions are expansive in growth, so removal of the tumor is bound to damage the pituitary stalk. Theoretically, all of these patients require long-term oral hormonal medications to supplement their physiological needs. The vast majority of patients in our hospital have abnormal post-operative endocrine tests, the most common being low cortisol levels, and a subset of patients also have thyroid hormones below normal levels. Our advice to patients is that the application of hormonal drugs mainly depends on whether the patient has the corresponding symptoms, and it is better to take less if possible and not to take them if possible without affecting normal life. As far as the recent review and return visits are concerned, some patients do not need long-term oral medication although their hormone levels are lower than normal in laboratory tests. There are a few patients with craniopharyngioma whose tumors grow out from the lateral side of the pituitary stalk. In such patients, the pituitary stalk is preserved during surgery, and the hormone level remains normal after surgery, so naturally they do not need to take oral medication. However, such patients are rare, accounting for only about 1-2% of all patients. 5.Can uremia be controlled? Answer: Polyhydramnios is also one of the common symptoms in patients with craniopharyngioma. It is mostly caused by the growth of the tumor to the posterior and superior, which compresses the hypothalamus and causes the decrease of anti-diuretic hormone secretion. Due to the effect of surgery, most of the patients, after surgery, will have transient enuresis, as short as 3-5 days or as long as 2 weeks, and most of the patients in the cut will eventually return to normal. However, for a small number of patients, because the tumor and hypothalamus are closely adhered to each other, and there are crossed arteries and veins between each other, it is difficult to avoid the formation of damage when the tumor is surgically removed, so there are long-term postoperative symptoms of urinary collapse, and oral medication is needed to control the urine volume. 6.Can the patient’s height be restored to normal? Answer: Due to the reduction of growth hormone secretion caused by tumor growth, the patient’s height is obviously lower than that of the same age group. Don’t expect anything else. If there is no recurrence within 2 years after surgical resection and the patient’s age is appropriate, exogenous growth hormone can be applied to promote height development. 7.Can patients get married and have children normally when they grow up? Answer: For patients with craniopharyngioma, because of the hormone level, the development of reproductive system of some patients is affected. After reaching the age of marriage and childbirth, testosterone can be applied to men, and estrogen and progesterone can be applied to women, and only after adjustment can they have children normally. Among the patients we have treated, there are also cases of normal marriage and childbirth without hormone treatment, but that is after all a minority.