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Abstract There are two main management pathways with regards to the treatment of the tumour. The first involves attempted gross total resection of the tumour , the second approach is for more limited surgery, aimed at debulking the tumour to reduce the mass effect on the optic pathways and/or to re-establish the cerebrospinal fluid pathways, followed by external beam radiotherapy or stereotactic radiosurgery (gamma knife); which show very promising results. The resent progress in high resolution imaging equipment (especially the MRI) showed the extent of the hypothalamic involvement which preoperatively guided the surgeon which patient is candidate for gross total removal and who is not. The extended endonasal approach is a very promising minimally invasive approach with many advantages but needs an experienced hand as well as some complications need to be solved as CSF leak. |