Craniopharyngiomas are benign tumors of the sellar region generally associated with endocrine disorders and often locally aggressive. The reliable criteria for predicting the tumor behavior are still lacking. It has been suggested that proliferative potential of the tumor cells is necessary for recurrence. The aim of this study was to evaluate the activity and correlation of epithelial cell adhesion molecule (Ep-CAM) and pituitary tumor transforming gene (PTTG-1) immunoexpression that is possibly related to relapse in 40 patients with adamantinomatous craniopharyngioma. The study involved clinical and pathologic analysis. Of the subjects, 49% were females and 51% were males. The mean age of the patients was 37 years. Relapsing rate at 5 years was 46% and for death was 22.5%. Histologically, whorl-like arrays and dense or hypercellular stellate reticulum cells were correlated with recurrence. Epithelial CAM and PTTG-1 were also higher in stellate reticulum cells and in whorl-like arrays. Both were higher in recurrence/regrowth tumors than in primary one. The PTGG-1 expression in craniopharyngioma may suggest hypophyseal metaplasia. The Ep-CAM and PTTG-1 expression in craniopharyngioma could be used as prediction markers of relapsing tumor. It has been suggested that proliferative potential of the tumor cells is necessary for recurrence.