Craniopharyngioma with obvious and large residuals can be known by imaging during and after surgery, and tiny and hidden residuals are often found when recurrence occurs 1~5 years after surgery.
The simple surgical method for craniopharyngioma is to remove the tumor as completely as possible without damaging the neurovascular and optic nerves. When the tumor is tightly adherent to important structures such as hypothalamus, optic nerve and internal carotid artery, and total excision of the tumor may lead to serious complications, the surgical goal is to reduce the size of the tumor, alleviate the pressure on the optic nerves, and rebuild the cerebrospinal fluid circulatory pathway, and supplemented with postoperative radiation therapy.
If the surgeon recognizes the difficulty of total resection during surgery, he will communicate with the family, and this will be known during the surgery. Postoperatively, irregular mass shadow on the saddle can be seen on CT plain scan, and plaque-like or eggshell-like calcified shadow can be seen on the wall of the capsule. Characteristic changes of the tumor can be observed on magnetic resonance and enhancement scans.
Tiny and insidious residual masses are most often detected by the presence of definite symptoms of endocrine dysfunction, visual disturbances, and intracranial hypertension when they recur 1 to 5 years after surgery.
When a craniopharyngioma is treated surgically, the receiving physician can be consulted to standardize the diagnosis and treatment.