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CPs are characterized by a low proliferation rate and symptoms due to mass effect and local infiltration and are managed primarily with surgery and radiotherapy. Gross total removal of a CP will reduce the recurrence rate but increases the risk of HT damage. Today, subtotal resection is the goal and will reduce the risk of HT damage. There are two histological subtypes of CP\u2014adamantinomatous (ACP) and papillary CP (PCP)\u2014that differ in their genesis and age distribution. ACPs are driven by somatic mutations in <jats:italic>CTNNB1<\/jats:italic> gene (encoding \u03b2\u2010catenin), and PCPs frequently harbor somatic BRAF V600E mutations. There are also two phenotypes of outcome, the one with a rather good outcome without HT damage and the other with HT damage where recurrent operation with additional cranial radiotherapy results in HT obesity (HO), affecting psychosocial life and cognitive dysfunction. The group with HO suffers from metabolic syndrome, lower basal metabolic rate, and leptin and insulin resistances. There is currently no successful treatment for HO. The group with HT damage suffers from cognitive dysfunction with attention deficits, impaired episodic memory, and processing speed. Diffusion tensor imaging has shown significant microstructural white matter alteration in several areas important for cognition. Recently, complete or partial tumor response was shown to targeted therapy, with BRAF and Mekinist inhibitors for PCPs with BRAF V600E mutation.<\/jats:p>","DOI":"10.1111\/joim.13684","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T06:16:35Z","timestamp":1688969795000},"page":"269-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Craniopharyngioma\u2014An update on metabolic and cognitive complications and new therapy"],"prefix":"10.1111","volume":"294","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4039-9725","authenticated-orcid":false,"given":"Eva Marie","family":"Erfurth","sequence":"first","affiliation":[{"name":"Department of Endocrinology Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1830-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)64477-X"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-005-1004-x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-012-0418-4"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2868"},{"key":"e_1_2_10_7_1","first-page":"2141","article-title":"MAPK pathway control of stem cell proliferation and differentiation in the embryonic pituitary provides insights into the pathogenesis of papillary craniopharyngioma","volume":"144","author":"Haston S","year":"2017","journal-title":"Development."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.9.FOCUS16304"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.4.0547"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3525"},{"key":"e_1_2_10_11_1","first-page":"3897","article-title":"Postoperative prognosis in craniopharyngioma with respect to cardiovascular mortality, survival, and tumour recurrence","volume":"11","author":"Bulow B","year":"1998","journal-title":"J Clin Endocrinol Metab."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04006-X"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2004.02196.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nov044"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0125-9"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.217"},{"key":"e_1_2_10_17_1","first-page":"1","article-title":"Preserve or sacrifice the stalk? 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