Craniopharyngioma of adamantinomatous type

Case contributed by Dr Mustafa Takesh

Presentation

Profound left optic neuropathy, to rule out a compressive lesion.

Patient Data

Age: 55 years
Gender: Male

Selected CT images demonstrating a large suprasellar mass composed of cystic and enhancing solid components with scattered tiny calcifications. Significant mass effect on the brainstem and 3rd ventricle with encasement of the basilar artery. 

Selected MRI images showing a large suprasellar/hypothalamic mass with cystic and solid enhancing components, resulting in a  significant mass effect on the third ventricle, midbrain and the pons. There are also hemorrhagic components. 

MRI

postoperative MRI two weeks later

In the interval, a left frontotemporal craniectomy has been carried out with partial resection of the large, suprasellar mass lesion. There is a significant improvement of the mass effect.

Case Discussion

Classic MRI features of a craniopharyngioma of adamantinomatous type with multiple cysts, some of which are filled with blood products. There are also calcifications, which often occur in the adamantinomatous type (in about 90% of cases). In general, craniopharyngiomas have a bimodal distribution with two peaks (between 5 and 15 years and over 40 years).

The histological report confirmed a craniopharyngioma of adamantinomatous type (WHO grade I).

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Case information

rID: 78150
Published: 9th Jul 2020
Last edited: 14th Jul 2020
Inclusion in quiz mode: Included
Institution: McGill University

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