Craniopharyngioma - 3rd ventricle

Case contributed by Dr Alexandra Stanislavsky


Sudden severe headache on the background of increasing intermittent headaches.

Patient Data

Age: 50 years
Gender: Male

Large heterogeneously enhancing third ventricular mass with innumerable T2 hyperintense/T1 hypointense small cysts. Subtle foci of T2 / GRE hypointensity suggest small foci of calcification. The mass is adjacent to but not in communication with the posterior clinoid process. 

There is no sellar or suprasellar extension and no transependymal edema.

Annotated image

Annotated images

The solid enhancing mass ( * ) is centered in the third ventricle, expanding the supraoptic recess (yellow arrow) and outwardly bowing the floor of the third ventricle (blue arrow). Superiorly the mass extends to the foramina of Monro (red arrows). 

It is clearly separate from the pituitary gland (white arrow). 

The patient went on to have a craniotomy and excision of the mass. 


Post excision pathology report notes scattered foci of keratin and focal calcification.

Final diagnosis: Third ventricular tumour - craniopharyngioma (WHO I)

Case Discussion

Intraventricular craniopharyngiomas are rare but certainly reported. Like this case, they are usually located in the third ventricle. 

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Case information

rID: 10642
Published: 29th Aug 2010
Last edited: 23rd Nov 2019
Inclusion in quiz mode: Included

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