Ectopic recurrences of craniopharyngioma

Background: Ectopic recurrences of craniopharyngioma after total surgical removal are a rare event. Two possible mechanisms of seeding have been proposed: the dissemination of tumoral cells during the surgical procedure would account for tumor recurrence along the surgical path, whereas the migration of tu-moral cells through the subarachnoid or Virchow-Robin spaces would explain ectopic recurrences far from the surgical bed or within the brain parenchyma. Case report: We report a unique case of metastatic craniopharyngioma recurring in a child after different intervals in which both the mechanisms could have taken place. The first ectopic seeding arose along the operative track of the primary surgical procedure in the frontal region while the second involved the deep cerebral nuclei and the brain stem. Outcome: The first recurrence was successfully operated upon. The following recurrences were not operated upon but remained stable for the last 4 years, thus showing dissociation between the capacity of seeding and invasivity.