Adamantinomatous craniopharyngioma

Case contributed by Dr Ahmed Abdrabou

Presentation

Headache and blurring of vision followed by discovery of suprasellar mass and hydrocephalus. VP shunt was placed.

Patient Data

Age: 14 years
Gender: Male

Large lobulated predominantly cystic suprasellar mass is noted. It elevates the 3rd ventricle, extends downward to the prepontine cistern and posteriorly to splay the crus cerebri. It displays iso intense signal in T1W and bright signal in T2W/FLAIR with no diffusion restriction or enhancement. Drainage catheter tip noted in the cystic component of the suprasellar mass. VP shunt is seen in situ.

Case Discussion

Craniopharyngioma (pathologically proven in this case) is a benign suprasellar mass that usually occurs in pediatric (5-15 years) and elderly (60-70 years)

Differential considerations include pituitary macroadenoma and Rathke's cleft cyst.

Editors note: Unfortunately additional diagnostic information is not available and it is uncertain whether this represents an adamantinomatous craniopharyngioma or papillary craniopharyngioma. Given baseline frequency particularly at this age and the dominant cystic component with intermediate-high T1 signal this most likely represents an adamantinomatous craniopharyngioma. 

For the purposes of this case, it almost certainly represents an adamantinomatous craniopharyngioma

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