Endoscopic endonasal management of papillary and adamantinomatous craniopharyngiomas: a comparative operative video with a proposed role for intraoperative Raman spectroscopy
Year: 2026
Type: article
Study design: Case Report
Abstract: Craniopharyngiomas comprise two molecularly distinct subtypes: papillary craniopharyngioma (PCP), driven by BRAF V600E mutations, typically presenting as solid, well-circumscribed third ventricular masses in adults; and adamantinomatous craniopharyngioma (ACP), driven by CTNNB1 mutations, featuring cystic-solid architecture with calcifications and hypothalamic adherences. Two representative cases illustrate their radiological and intraoperative differences via the extended endoscopic endonasal approach. Subtype identification through MRI, intraoperative frozen-section analysis, and CSF liquid biopsy is critical, as it directly shapes surgical strategy and postoperative decisions, including BRAF/MEK inhibitor therapy for PCP. Raman spectroscopy holds promise as a future real-time intraoperative discrimination tool. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID26127.
Source: Neurosurgical Focus Video
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214008886