Exploring the pathological relationships between adamantinomatous craniopharyngioma and contiguous structures with tumor origin

Purpose Identifying relationships between craniopharyngiomas (CPs) and contiguous structures, and tumor origin are crucial for treatments. This study attempted to explore the relationships and tumor origin. Methods CPs that underwent endoscopic surgeries were enrolled. The interfacial specimens of CPs attaching the hypothalamus, pituitary stalk (PS), pituitary grand (PG), optic chiasma (OC) and brain tissue (BT) were pathologically examined. Boundaries between CPs and these structures were observed during operations. Expression of beta-catenin and stem cell markers were analyzed to explore the tumor origin. Outcomes of patients were assessed. Results A total of 34 CPs were categorized into two groups based on the locations of finger-like protrusions (FP). Group A comprised 18 CPs with FP only present in the specimens attaching to hypothalamus. The surface of these CPs was fused with hypothalamus under endoscopic videos. However, the specimens attaching to the PS, PG, OC, and BT showed no FP. Clear boundaries was observed between these CPs and these structures. Group B comprised 16 CPs with FP only present in the specimens attaching to PS. The tumor surface was fused with PS. Specimens attaching to the hypothalamus, PG, OC and BT showed no FR. Clear boundary was observed among these CPs with these structures. These results implied CPs only invaded a certain part of hypothalamic-pituitary axis. beta-catenin and stem cells markers mainly distributed in the FP tissues of both groups. Patients in group B achieved better outcomes than group A. Conclusions CPs only invade the hypothalamic-pituitary axis with FP and the FP would be the tumor origin.

Automated summary

This study investigated the relationships between craniopharyngiomas (CPs) and contiguous structures, as well as the origin of the tumor. The results showed that CPs only invade a certain part of the hypothalamic-pituitary axis, and the finger-like protrusions (FP) may be the tumor origin.