The patient went on to have surgery.

Histology

Paraffin sections show a small fragment of anterior pituitary tissue and a separate fragment of craniopharyngioma. The latter is composed of irregularly shaped epithelial islands with a peripheral basaloid cell layer and stellate reticulum. No keratinization is seen. The fragment shows a central small cyst filled with amorphous material. The anterior pituitary fragment is composed largely of corticotroph cells with strong immunostaining for ACTH. There is patchy strong staining for TSH and staining of individual cells for prolactin.

FINAL DIAGNOSIS: adamantinomatous craniopharyngioma

Discussion

Adamantinomatous craniopharyngiomas are usually encountered in children.