The patient underwent a right-sided pterional craniotomy and resection of the suprasellar mass.
Histology
In both specimens, there are sheets of epithelium with regular peripheral palisading of nuclei and a loosely reticular central arrangement. Numerous small cystic spaces are formed. The nuclei are uniform, lacking pleomorphism and mitoses are inconspicuous. Focally, there is dystrophic calcification. There is no evidence of necrosis.
Final Diagnosis:
Adamantinomatous craniopharyngioma.
Follow-up
Post-operatively, the patient’s recovery complicated by hypopituitarism, medically managed with thyroxine and hydrocortisone. His vision, however, improved markedly, returning to normal visual acuity (6/6 bilaterally) and normal visual fields. Follow-up imaging at the post-operative 8 week juncture demonstrated adequate debulking of the tumor, and less pronounced stretching and displacement of the optic chiasm and optic nerves.