Tehran University of Medical Sciences Immunology and Genetics Journal 2645-4831 9 2 2026 06 29 230 230 Sara Hanaei Department of Neurosurgery, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Borderless Research, Advancement and Innovation in Neuroscience Network (BRAINet), Tehran, Iran Arezou Rezaei Research Center for Immunodeficiencies (RCID), Tehran University of Medical Sciences (TUMS), Tehran, Iran Farid Azmoudeh Ardalan Department of Pathology, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran Seyed Mousa Sadrehosseini Department of Otolaryngology-Head and Neck Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nima Rezaei 3. Research Center for Immunodeficiencies (RCID), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Mehdi Zeinalizadeh Department of Neurosurgery, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences (TUMS), Tehran, Iran 2026 05 03 2026 05 03 Background: Craniopharyngiomas are benign but locally aggressive sellar tumors with high postoperative morbidity. The BRAF V600E mutation is a hallmark of the papillary subtype, yet its prognostic significance remains controversial. Most studies have focused on papillary craniopharyngiomas, while the potential role of BRAF gene variations in clinical outcomes across both subtypes has been underexplored. This study investigated the association of BRAF single nucleotide polymorphism with clinical characteristics and postoperative outcomes in patients with craniopharyngioma. Methods: The current historical cohort study included 47 patients with histopathologically confirmed craniopharyngioma who underwent endoscopic endonasal resection. BRAF rs113488022 genotyping (TT, TC, CC) was performed on DNA extracted from formalin-fixed paraffin-embedded tumor specimens using real-time PCR. Associations between genotypes and histopathological subtype, tumor volume, calcification, lobulation, extent of resection, postoperative complications, recurrence, and mortality were analyzed. Results: The patients included 26 males (55.3%) and 21 females (44.7%), with a mean age of 25.06 ± 17.17 years. The most frequent BRAF rs113488022 genotype was 'TC' (76.6%), followed by 'CC' (14.9%) and 'TT' (8.6%). A significant difference in genotype distribution was observed between adamantinomatous and papillary craniopharyngiomas (P=0.024), with the 'CC' genotype being more common in the papillary subtype. No significant associations were found between BRAF rs113488022 genotypes and tumor volume (P=0.93), calcification (P=0.61), lobulation (P=0.34), extent of resection (P=0.47), recurrence (P=0.55), mortality (P=0.13), or postoperative complications including diabetes insipidus, visual changes, and BMI changes (all P>0.05). Conclusion: While BRAF rs113488022 genotype distribution differs significantly between histopathological subtypes and serves as a valuable diagnostic marker, it does not independently predict postoperative surgical outcomes, recurrence, or mortality in craniopharyngioma patients. Larger prospective studies are needed to further elucidate the prognostic significance of specific BRAF SNPs. https://igj.tums.ac.ir/index.php/igj/article/view/230