Recurrent ectopic craniopharyngioma in the sylvian fissure thirty years after resection through a pterional approach: a case report and review of the literature

Abstract

Local recurrence of craniopharyngiomas after apparently complete resection occurs frequently. Ectopic recurrence remote from the original site has been reported in 18 adult patients. The interval between the original diagnosis and the time of recurrence varies widely in these reports (1-26 years). We report a case of an ectopic recurrence in the sylvian fissure of an adamantinomatous type craniopharyngioma 34 years after the initial presentation and 30 years after the last surgical resection. In addition to this being the latest reported ectopic recurrence, the location of this new lesion in the sylvian fissure is fairly rare, having been reported in only three other cases. We also reviewed the English literature for reports of ectopic recurrent craniopharyngiomas in order to conduct an analysis of surveillance and treatment strategies.

Keywords: craniopharyngioma treatment; metastatic craniopharyngioma; recurrent craniopharyngioma.

Fig. 1

A. Axial head CT w/o contrast showing incidentally found 1.7 × 1.2 cystic lesion in left temporal lobe along the previous craniotomy tract. B. Axial head CT with contrast showing ring enhancing cystic lesion with increase in size to 3.2 × 2.2 cm

Fig. 2

Intraoperative photograph of the mass

Fig. 3

Third year follow up CT head with contrast demonstrating no recurrence of the cystic mass at the surgical bed or anywhere else in brain.