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Neuro-Oncology 2002 4(2):123-128; doi:10.1093/neuonc/4.2.123
© 2002 by Society
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© 2002 by the Society forNeuro-Oncology

Metastatic papillary craniopharyngioma: Case study and study of tumorangiogenesis

Lhan Elmaci, Özlem Kurtkaya-Yapicier, Gazanfer Ekinci, Ayd?n Sav, M. Necmettin Pamir, Sergio Vidal, Kalman Kovacs and Bernd W. Scheithauer1

Departments of Neurosurgery (L.E., M.N.P.), Neuropathology (Ö.K.-Y., A.S.), and Radiology (G.E.), Marmara University School of Medicine,Istanbul, Turkey; Department of Anatomy, Universitariode Santiago de Compostela, Lugo, Spain (S.V.); Department of Laboratory Medicine, St. Michael's Hospital,Toronto, Ontario, Canada (K.K.); and the Department ofPathology and Laboratory Medicine, Mayo Clinic, Rochester, MN 55905(B.W.S.)

1 Address correspondence and reprint requests to B. W. Scheithauer, Departmentof Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St. SW, Rochester,MN 55905.


  Abstract

We report a case of suprasellar papillary craniopharyngioma metastatic tothe temporoparietal region 2 years after its initial resection. The literaturedocuments examples of craniopharyngioma recurrences along the surgical tract,as well as remote ipsi- and contralateral metastases via cerebrospinal fluidseeding. Ours is the second report of a craniopharyngioma of papillary type toexhibit metastatic behavior. The tumor spread opposite the side of craniotomy.Although a rare occurrence, it confirms the limited capacity of histologicallybenign craniopharyngiomas to undergo meningeal seeding, likely the result ofsurgical manipulation. Immunohistochemical demonstration of increasedmicrovascular density and vascular endothelial growth factor expression, aswell as a high vascular endothelial growth receptor (VEGFR2) signal by in situhybridization, suggests that tumor vascularity facilitated angiogenesis andmay have been involved in the establishment and growth of the metastaticdeposit.

Received September 5, 2001; Accepted November 19, 2001


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