Presentation
Growing intracranial suprasellar mass in the last 10 years.
Patient Data
There is a heterogeneous, partially hyperintense, suprasellar mass.
Suprasellar mass showing mixed-signal and patchy heterogeneous enhancement following gadolinium. It also shows some rim enhancement. It contacts and partly displaces the optic chiasm and bears a close relationship to the pituitary stalk and the pituitary contents. No restriction or diffusion.
Sections show a papillary tumor composed of mature squamous epithelium with underlying stroma. The epithelium lacks a granular cell layer but contains scattered goblet cells and neutrophils. No skin adnexal structures are seen. The loose stroma appears edematous. No stellate reticulum is seen. There is no evidence of malignancy.
DIAGNOSIS: papillary craniopharyngioma.
Case Discussion
The papillary craniopharyngiomas are seen almost exclusively in adults and is formed of masses of metaplastic squamous cells. Cysts do form, but these are less of a feature, and the tumor is more solid. Calcification is uncommon or even rare.