Craniopharyngioma (adamantinomatous)

Case contributed by Dr Erik Ranschaert

Presentation

Headaches for 4 weeks mainly in the evenings and during the night, no visual disturbances.

Patient Data

Age: 11 years
Gender: Female
MRI

MRI pituitary region

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

A craniopharyngioma typically involves the sella and suprasellar space (see images). Some craniopharyingiomas can be both intrasellar and suprasellar, having a "snowman" appearance.

The adamantinomatous subtype appears as a predominately cystic suprasellar mass with a solid component (as in this case).  

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 craniopharyingioma from Rathke's cleft cyst or pituitary adenoma.
PlayAdd to Share

Case information

rID: 12530
Published: 12th Dec 2010
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.