Presentation
Headaches for 4 weeks mainly in the evenings and during the night, no visual disturbances.
Patient Data
Age: 11 years
Gender: Female
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A suprasellar nodular mass with cystic components. The solid component is located above the pituitary gland. The post-contrast acquisition demonstrates enhancement of the solid nodule and walls of the cystic component.
Evidence of obstructive hydrocephalus of the lateral ventricle with transependymal edema.
Case Discussion
Adamantinomatous craniopharyngiomas typically involve the sella and suprasellar space. Some craniopharyingiomas can be both intrasellar and suprasellar, having a "snowman" appearance.
Description of MRI findings:
- cystic area which is hyperintense on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images with heterogeneous isointense to hypointense solid components in the caudal part.
- signal intensity varies on T1-weighted images. The cystic contents can appear hyperintense if they have a high protein, blood product, and/or cholesterol content. In this case the cystic component is T1-isointense.
- contrast enhancement is seen, which is characteristic.
- compression of the third ventricle may occur and hydrocephalus may be present. Such compression helps in distinguishing craniopharyngioma from Rathke's cleft cyst or pituitary adenoma.
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