Different tests are available to diagnose childhood craniopharyngioma, depending on signs and symptoms, age and health status, types of tumor, and earlier medical tests. Detailed physical examinations, biopsy, blood and urine tests, and various imaging tests and procedures are the standard diagnostic approach for childhood craniopharyngioma. Other diagnostic tests for childhood craniopharyngioma include imaging tests such as Computed tomography (CT or CAT) scan, and Magnetic Resonance Imaging (MRI), besides physical examinations and blood and urine tests.
Diagnosis of Childhood Craniopharyngioma
Childhood craniopharyngioma is a rare benign brain tumor type, usually seen near the pituitary gland and the hypothalamus. The actual cause of craniopharyngioma is still unknown. Doctors use various techniques to diagnose this disease.
This includes detailed physical examinations, biopsy, blood and urine tests, and various imaging tests and procedures 1. A thorough diagnosis of craniopharyngioma helps doctors decide the best treatment strategy for an individual’s disease condition.
The diagnosis procedures of craniopharyngioma where the doctor recommends would be dependent on the individual’s disease condition. The doctor may consider the following factors concerning the disease before choosing the diagnostic procedures:
- Type of the tumour
- Its stage and grade
- Signs and symptoms experienced by the child/adult.
- Past medical history. The results of past medical check-ups and tests.
The following are the procedures used for the diagnosis of craniopharyngioma. Not all the procedures or tests will be used for every child’s disease condition.
- PHYSICAL EXAMINATION
The doctor will conduct a detailed physical examination of your child’s body and head (suspected areas). They will enquire about the signs and symptoms that your child is experiencing. You may also be required to produce your child’s past medical history for reference. As per the physical examination, the doctor will prescribe more tests and scans, especially to analyze the child’s growth, development, vision, and brain function 2.
- URINE AND BLOOD TESTS
Blood and urine tests are standard tests used to analyze most disease conditions. The doctor may prescribe a blood test primarily to measure the levels of certain body hormones. If your child is experiencing signs like increased urination or excessive thirst, a urine test would be recommended to monitor the kidney functions 3.
A biopsy is considered a sure shot method to detect most types of tumors. The procedure refers to removing a small tissue from the suspected area to be examined in a laboratory in detail. In the case of craniopharyngioma, a neurosurgeon (a specialist in CNS surgery) will extract a part of the tumor or remove the entire tumor during surgery. Once the sample is extracted, it is sent to the laboratory and is analyzed by a pathologist. The pathologist will examine the sample under a microscope and evaluate the cells and tissues to diagnose the disease. In the cases of brain tumors like craniopharyngioma, a neuropathologist who is specialized in analyzing CNS tissues and disorders will examine the sample tissue. In most cases, the neurosurgeon will try to safely remove parts of the tumor without causing any damage to the brain.
If a biopsy is impossible in a particular case, the doctor will prescribe other diagnostic procedures.
- IMAGING TESTS
In order to diagnose a disease condition like craniopharyngioma, imaging tests would be required besides physical examinations and blood and urine tests. Imaging tests provide a clear picture of the disease condition, as these tests can provide images of the body interior. The following are the two major imaging tests used to detect craniopharyngioma 4:
COMPUTED TOMOGRAPHY/ CT/ CAT SCAN
A CT scan uses x-rays to capture images of the brain’s interior from different angles. Once these images are captured, a computer will combine them into detailed three-dimensional pictures that can show any defaults or abnormalities like tumors. At times, a special dye called a contrast medium is injected into the patient’s vein during the scan to get detailed results.
- MAGNETIC RESONANCE IMAGING/ MRI
An MRI scan uses magnetic fields instead of X-rays to capture detailed images of the brain’s interior or spinal column. MRI can also detect the size of a tumor. A special dye called a contrast medium is injected into the patient’s vein before the scan to get clear images.
Once all these diagnostic procedures are done, the doctor will examine the results thoroughly and discuss the observations with you. Based on these test results, the doctor will design the treatment strategy to treat and cure the disease condition.
- 1.Müller HL. Childhood craniopharyngioma—current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol. Published online September 28, 2010:609-618. doi:10.1038/nrendo.2010.168
- 2.Müller HL, Emser A, Faldum A, et al. Longitudinal Study on Growth and Body Mass Index before and after Diagnosis of Childhood Craniopharyngioma. The Journal of Clinical Endocrinology & Metabolism. Published online July 1, 2004:3298-3305. doi:10.1210/jc.2003-031751
- 3.Bogusz A, Müller HL. Childhood-onset craniopharyngioma: latest insights into pathology, diagnostics, treatment, and follow-up. Expert Review of Neurotherapeutics. Published online October 3, 2018:793-806. doi:10.1080/14737175.2018.1528874
- 4.Harwood-Nash DC. Neuroimaging of Childhood Craniopharyngioma. Pediatr Neurosurg. Published online 1994:2-10. doi:10.1159/000120853