What is the main differential diagnosis of a suprasellar mass ?
Pituitary adenoma, Rathke cleft cyst, craniopharyngioma, and epidermoid cyst (refs. 1 and 2).
What is the incidence of craniopharyngioma ?
Craniopharyngioma represents about 3% of all brain tumors. This number increases up to 10% in the pediatric population (ref. 4).
What are the two histological types of craniopharyngioma?
Adamantinomatous papillary craniopharyngioma (refs. 3 and 4).
Which variant is more prone to demonstrate coarse calcification?
The adamantinomatous type is more prone to calcification (refs. 3 and 4).
MRI brain confirms the presence of a partially calcified suprasellar lesion extending in the anterior portion of the third ventricle and interpeduncular cistern.
The superior part of the lesion is round and well-circumscribed, with a hyperintense T1 signal and an intermediate-high T2 signal, in keeping with a cystic/proteinaceous component. The inferior part of the lesion is more irregular, demonstrating both enhancing solid component and coarse calcifications.
The lesion is associated with obstructive hydrocephalus, with dilatation of the lateral ventricles due to obstruction of the interventricular foramen and evidence of periventricular transependymal CSF flow.