Presentation
Occipital headache, visual disturbance and an episode of generalized tonic colonic seizure. No fever or vomiting. Past history of primary amenorrhea, hypothyroidism and anemia.
Patient Data
Sizable hypodense sellar and suprasellar mass lesion, causing expansion of the sella turcica, having peripheral calcifications, measuring about 5.0 x 3.0 x 1.7 cm. Dilated lateral ventricles with mild periventricular CSF permeation, suggestive of obstructive hydrocephalus.
Well-defined, sellar and suprasellar mass lesion causing expansion of the sella. It has peripheral solid and central cystic components, as well as few calcifications. Solid components show moderate enhancement on the post-contrast study. Superiorly, the lesion is compressing both optic nerves and optic chiasma, and extending into the 3rd ventricle, leading to obstructive hydrocephalus. Internal carotid arteries are seen at its periphery and are not encased.
Case Discussion
Procedure: craniotomy and tumor debulking.
Diagnosis: adamantinomatous craniopharyngioma, WHO grade 1.
Case courtesy of Dr. Mohamed Khalifa.