Craniopharyngiomas are most commonly located in the intradural suprasellar region. However, ectopic craniopharyngiomas can originate in the infrasellar region. The authors present the case of an 8-year-old boy diagnosed with a large cystic craniopharyngioma involving the nasal cavities and maxillary, ethmoid and sphenoid sinuses, in addition to the sella turcica. The primary symptoms of this patient were nasal obstruction, unilateral decreased visual acuity and exophthalmos. He subsequently underwent combined radical resection of the tumor by means of an endonasal transsphenoidal approach followed by radiation therapy. During the surgery, the dura mater of the sellar floor was found to be intact. The neuroradiological and surgical findings suggested that this tumor originated in the extradural infrasellar region and invaded the sella turcica.

1.
Erdheim J: Über Hypophysengangsgeschwülste und Hirncholesteatome. Akad Wiss Wien 1904;113:537–726.
2.
Samii M, Tatagiba M: Surgical management of craniopharyngiomas: A review. Neurol Med Chir (Tokyo) 1997;37:141–149.
3.
Kobayashi T: Recent progress in the treatment of craniopharyngioma. Neurosurgery 1984;3:101–112.
4.
Rougerie J: What can be expected from the surgical treatment of craniopharyngiomas in children? Report of 92 cases. Childs Brain 1979;5:433–449.
5.
Akimura T, Kameda H, Abiko S, Kido T: Infrasellar craniopharyngioma. Neuroradiology 1989;31:180–183.
6.
Benitez WI, Sartor KJ, Angtuaco EJ: Craniopharyngioma presenting as a nasopharyngeal mass: CT and MR findings. J Comput Assist Tomogr 1988;12:1068–1072.
7.
Bret PH, Beziat JL: Craniopharyngiome sphénoïdo-naso-pharyngé: un cas avec exérèse radicale par maxillotomie de Le Fort I. Neurochirurgie 1993;39:235–240.
8.
Bock E: Beitrag zur Pathologie der Hypophyse. Virchows Arch Pathol Anat 1924;252:98–112.
9.
Byrne MN, Sessions DG: Nasopharyngeal craniopharyngioma. Case report and literature review. Ann Otol Rhinol Laryngol 1990;99:663–639.
10.
Chakrabarty A, Mitchell P, Bridges LR: Craniopharyngioma invading the nasal and paranasal spaces, and presenting as nasal obstruction. Br J Neurosurg 1998;12:361–363.
11.
Cheddadi D, Triki S, Gallet S, Marquet M, Muller JP, Renaud H, Goddon R: Obstruction rhinopharyngée néonatale par craniopharyngiome. Arch Pédiatr 1996;3:348–351.
12.
Chen CJ: Suprasellar and infrasellar craniopharyngioma with a persistent craniopharyngeal canal: Case report and review of the literature. Neuroradiology 2001;43:760–762.
13.
Cooper PR, Ransohoff J: Craniopharyngioma originating in the sphenoidal bone. Case report. J Neurosurg 1972;36:102–106.
14.
Drummond WAD: Infrasellar adamantinoma. Proc R Soc Med 1938;31:200–207.
15.
Falavigna A, Kraemer JL: Infrasellar craniopharyngioma: Case report. Arq Neuropsiquiatr 2001;59:424–430.
16.
Fujitani K, Hakuba A, Kojima S, Mishima Y, Tsujimoto T, Nishimura S: Craniopharyngioma, originating in the sphenoid sinus, extending into the nasal cavity (in Japanese). No Shinkei Geka 1979;7:181–186.
17.
Bernat Gili A, Garcia Garcia B: Craneofaringioma de nasofaringe. A propósito de un caso. Acta Otorrinolaringol Esp 1991;42:269–272.
18.
Graziani N, Donnet A, Bugha TN, Dufour H, Figarella-Branger D, Grisoli F: Ectopic basisphenoidal craniopharyngioma: Case report and review of the literature. Neurosurgery 1994;34:346–349.
19.
Hamberger CA, Hammer G, Norlén G, Sjögren G: Surgical treatment of craniopharyngioma. Radical removal by the transantrosphenoidal approach. Acta Otolaryngol 1960;52:285–292.
20.
Herrmann G: Kasuistischer Beitrag zu den Hypophysentumoren. Med Klin 1923;19:826–828.
21.
Herzog J, Makek M, Fisch U: Lesions of Rathke’s duct: Another indication for the infratemporal fossa approach. Otolaryngol Head Neck Surg 1989;101:302–308.
22.
Hillman TH, Peyster RG, Hoover ED, Nair S, Finkelstein SD: Infrasellar craniopharyngioma: CT and MR studies. J Comput Assist Tomogr 1988;12:702–704.
23.
Ishiyama R, Yasue M, Sanada S, Yuki K, Nakamura N: Rare cases of craniopharyngioma, extending into the nasopharynx – two case reports (in Japanese). Neurol Med Chir (Tokyo) 1977;17:71–77.
24.
Illum P, Elbrønd O, Nehen AM: Surgical treatment of nasopharyngeal craniopharyngioma. Radical removal by the transpalatal approach. J Laryngol Otol 1977;91:227–233.
25.
Jiang RS, Wu CY, Jan YJ, Hsu CY: Primary ethmoid sinus craniopharyngioma: A case report. J Laryngol Otol 1998;112:403–405.
26.
Johnson NE: Craniopharyngioma – review with a discussion of transpalatal approach. Laryngoscope 1962;72:1731–1749.
27.
Kanungo N, Just N, Black M, Mohr G, Glikstein R, Rochon L: Nasopharyngeal craniopharyngioma in an usual location. AJNR Am J Neuroradiol 1995;16:1372–1374.
28.
Lewin R, Ruffolo E, Saraceno C: Craniopharyngioma arising in the pharyngeal hypophysis. South Med J 1984;77:1519–1523.
29.
Maiuri F, Correiro G, Elefante R, Cirillo S, Giamundo A: Craniopharyngioma of the cranial base and nasopharynx. Surg Neurol 1987;27:191–194.
30.
Maier HC: Craniopharyngioma with erosion and drainage into the nasopharynx. An autobiographical case report. J Neurosurg 1985;62:132–134.
31.
Majlessi H, Shariat AS, Katirai A: Nasopharyngeal craniopharyngioma. Case report. J Neurosurg 1978;49:119–120.
32.
Mukada K, Mori S, Matsumura S, Uozumi T, Goishi J: Infrasellar craniopharyngioma. Surg Neurol 1984;21:565–571.
33.
Northfield DWC: Rathke-pouch tumors. Brain 1957;80:293–312.
34.
Mozota Ortiz JR, Medina Sola JJ, Aguado Martinez F, Alfaro Garcia J, Hueto Pradi J: Craneofaringioma de cavum: Aportación de un caso. Acta Otorrinolaringol Esp 1988;39:119–121.
35.
Pharaboz C, Merran S, Cordoliani Y, Rizzoli P: Craniopharyngiome «rhinopharyngé»: aspect TDM et IRM. J Radiol 1989;70:573–575.
36.
Pheline C, Jamois Y, Engel PH, Leguyarder B, Penot JC: Craniopharyngiome ectopique basi-sphénoïdal. Abord par voie basse, naso-septale, puis antro-ethmoïdale. Neurochirurgie 1981;27:221–224.
37.
Podoshin L, Rolan L, Altman MM, Peyser E: ‘Pharyngeal’ craniopharyngioma. J Laryngol Otol 1970;84:93–99.
38.
Prasad U, Kwi NK: Nasopharyngeal craniopharyngioma. J Laryngol Otol 1975;89:445–452.
39.
Sato M: A tumor originating from the remnant of the hypophyseal duct in the sella turcica (in Japanese). Tohoku Ishi 1944;27:692.
40.
Sener RN: Giant craniopharyngioma extending to the anterior cranial fossa and nasopharynx. AJR Am J Roentgenol 1994;162:441–442.
41.
Trible WM: Destructive lesions of the sphenoid. South Med J 1970;63:849–852.
42.
Zeitlin H: Adamantinomas of the hypophyseal stalk and sphenoid bone. Am J Cancer 1935;23:729–740.
43.
Yaşargil MG: Microsurgery of CNS Tumors, IVB. Stuttgart, Thieme, 1996, pp 205–223.
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