Abstract
Purpose
Fusiform dilatations of the internal carotid artery (FDCA) represent a vascular complication following surgery for suprasellar tumors in children. Incidence rate and long-term prognosis of FDCA in terms of survival rates, vascular complications, and quality of survival are unknown for patients with childhood-onset craniopharyngioma.
Methods
Magnetic resonance imaging (MRI) results of 583 patients with childhood-onset craniopharyngioma, recruited from 2001 to 2015 in the German Childhood Craniopharyngioma Registry, were reviewed for FDCA. Risk factors for FDCA and long-term outcome after FDCA were analyzed.
Results
Fourteen of 583 patients (2.4 %) developed FDCA based on reference assessment of MRI. FDCA occurred ipsilateral to the surgical approach and was not related to degree of resection, hypothalamic involvement, or irradiation. The median time interval between first detection of FDCA and initial surgery was 0.79 years (range 0.01–5.56 years). During a median follow-up of 6.47 years (range 1.2–21.9 years) after first detection of FDCA, no bleeding or cerebrovascular events were observed in any patient. Irradiation was not related to FDCA. Survival rates and functional capacity were similar in patients with and without FDCA. Clinically the FDCA was unapparent in all cases and not treated.
Conclusion
FDCA is a rare complication related to surgical treatment of childhood-onset craniopharyngioma without major impact on prognosis and clinical course of the disease.
Clinical trial number
KRANIOPHARYNGEOM 2000—NCT00258453; KRANIOPHARYNGEOM 2007—NCT01272622.
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Acknowledgments
The authors are grateful for the help of Mrs. Margarita Neff-Heinrich (Göttingen, Germany) in proofreading and editing the manuscript. HL Müller is supported by a Grant (DKS 2010.22 Müller) provided by the German Childhood Cancer Foundation, Bonn, Germany.
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Hoffmann, A., Warmuth-Metz, M., Lohle, K. et al. Fusiform dilatation of the internal carotid artery in childhood-onset craniopharyngioma: multicenter study on incidence and long-term outcome. Pituitary 19, 422–428 (2016). https://doi.org/10.1007/s11102-016-0722-5
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DOI: https://doi.org/10.1007/s11102-016-0722-5