AUTHOR=Meyer Scott , Shah Shruti N. , Dancel-Manning Kristen , Wang Yuxiu , Young Matthew , Agrawal Nidhi TITLE=A case-based review of adult-onset craniopharyngioma JOURNAL=Frontiers in Endocrinology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1527161 DOI=10.3389/fendo.2025.1527161 ISSN=1664-2392 ABSTRACT=Craniopharyngiomas are histologically benign central nervous system tumors derived from embryonic epithelial cells of Rathke’s pouch. The disease demonstrates a bimodal age distribution, occurring most often in patients 5-14 and 50-74 years of age. Common comorbidities include hypopituitarism, hypothalamic obesity, sleep apnea, visual impairment and neurocognitive disturbances. There are several key differences in the presentation, tumor characteristics and clinical outcomes between age groups. Childhood craniopharyngiomas are mostly adamantinomatous and often present as larger tumors with worse functional outcomes such as rates of obesity and neurological deficits. Adults experience similar but slightly adjusted rates of comorbidity with both the adamantinomatous and papillary subtypes. This review presents a case-based discussion of adult craniopharyngiomas, focusing on recent literature regarding their presentation, pathology and pathogenesis, diagnosis, treatment and long-term sequelae.