Headache and blurring of vision followed by discovery of suprasellar mass and hydrocephalus. VP shunt was placed.
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Large lobulated predominantly cystic suprasellar mass is noted. It elevates the 3rd ventricle, extends downward to the prepontine cistern and posteriorly to splay the crus cerebri. It displays iso intense signal in T1 and bright signal in T2 and FLAIR with no diffusion restriction or enhancement. VP shunt is seen in situ.
Craniopharyngioma (pathologically proven in this case) is a benign suprasellar mass that usually occurs in pediatric (5-15 years) and elderly (60-70 years) and believed to arise from Rathke's cleft remnant. Differential considerations include pituitary macroadenoma and Rathke's cleft cyst.