Malignant craniopharyngiomas can occur at any age, are slightly more common in females, and are usually of the adamantinomatous type.The malignant transformations can take years to occur (although one in five of the diagnosed cases were de novo transformations), hence the need for lengthier follow-up in patients diagnosed with the more common benign forms.No link has been found between malignancy and initial chemoradiotherapy treatment, and the overall survival rate was very poor with median survival being 6 months after diagnosis of malignancy. Prevention
Although the causes of craniopharyngioma are unknown, it can occur in both children and adults, with a peak in incidence at 9 to 14 years of age. About 120 cases are diagnosed each year in the United States in patients under the age of 19. More than 50% of all patients with craniopharyngioma are under the age of 18 years. No clear association of the tumor exists with a particular gender or race. Craniopharyngiomas do not appear to "run in families" or to be directly inherited from the parents. Treatment
Treatment generally consists of subfrontal or transsphenoidal excision. Endoscopic surgery through the nose often performed by a joint team of neurosurgeons and ENT, is increasingly being considered as an alternative to transcranial surgery done by making an opening in the skull. Because of the location of the craniopharyngioma near the brain and skullbase, a surgical navigation system might be used to verify the position of surgical tools during the operation.Additional radiotherapy is also used if total removal is not possible.
A craniopharyngioma is a rare type of brain tumor derived from pituitary gland embryonic tissue that occurs most commonly in children, but also affects adults. It may present at any age, even in the prenatal and neonatal periods, but peak incidence rates are childhood-onset at 5–14 years and adult-onset at 50–74 years. People may present with bitemporal inferior quadrantanopia leading to bitemporal hemianopsia, as the tumor may compress the optic chiasm. It has a point prevalence around two per 1,000,000. Craniopharyngiomas are distinct from Rathkes cleft tumours and intrasellar arachnoid cysts. Symptoms and signs
Craniopharyngiomas are almost always benign. However, as with many brain tumors, their treatment can be difficult, and significant morbidities are associated with both the tumor and treatment. Headache (obstructive hydrocephalus)
Hypersomnia
Myxedema
Postsurgical weight gain
Polydipsia
Polyuria (diabetes insipidus) 
Vision loss (bitemporal hemianopia)
VomitingOften occurs after treatment
Growth hormone (GH) insufficiency, caused by the reduction in GH production - symptoms include:
Stunted growth and delayed puberty (in children)
General fatigue, loss of muscle mass and tone (in adults)
Pituitary insufficiency
Often occurs to some degree because craniopharyngiomas develop in the area of the pituitary stalk, which can affect the function of the pituitary gland and many other hormones
Reduction in prolactin production is very uncommon and occurs with severe pituitary insufficiency. Large pituitary tumors can paradoxically elevate blood prolactin levels due to the "stalk effect". This elevation occurs as a result of the compression of the pituitary stalk, which interferes with the brains control of prolactin production.