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Peer-reviewedCC BY 4.0Neurosurgical Focus: Video

Endoscopic endonasal management of papillary and adamantinomatous craniopharyngiomas: a comparative operative video with a proposed role for intraoperative Raman spectroscopy

  • Nesrine Jemel1
  • Ana Bokasova2,3
  • Najib Nassiri2,3
  • Philippe Lavigne4
  • Frederic Leblond2,3
  • Moujahed Labidi1,3
4 affiliations
  1. 1Division of Neurosurgery, Centre Hospitalier de L’Université de Montréal (CHUM), Québec
  2. 2Lumedlab, Polytechnique Montréal
  3. 3Centre de recherche du CHUM (CRCHUM), Montréal; and
  4. 4Division of Otolaryngology–Head and Neck Surgery, Centre Hospitalier de L’Université de Montréal (CHUM), Québec, Canada
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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

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Cite

BibTeXRIS
BibTeX
@article{jemel2026endoscopic,
  title = {{Endoscopic endonasal management of papillary and adamantinomatous craniopharyngiomas: a comparative operative video with a proposed role for intraoperative Raman spectroscopy}},
  author = {Nesrine Jemel and Ana Bokasova and Najib Nassiri and Philippe Lavigne and Frederic Leblond and Moujahed Labidi},
  journal = {Neurosurgical Focus: Video},
  year = {2026},
  month = oct,
  doi = {10.3171/2026.7.focvid26127},
  url = {https://doi.org/10.3171/2026.7.focvid26127},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Endoscopic endonasal management of papillary and adamantinomatous craniopharyngiomas: a comparative operative video with a proposed role for intraoperative Raman spectroscopy
AU  - Nesrine Jemel
AU  - Ana Bokasova
AU  - Najib Nassiri
AU  - Philippe Lavigne
AU  - Frederic Leblond
AU  - Moujahed Labidi
PY  - 2026
DA  - 2026/10/01
JO  - Neurosurgical Focus: Video
DO  - 10.3171/2026.7.focvid26127
UR  - https://doi.org/10.3171/2026.7.focvid26127
AB  - 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
SN  - 2643-5217
ER  -