Presentation
One week of headaches and blurred vision.
Patient Data
.
MRI of the pituitary demonstrates a heterogeneously T1 and T2 hyperintense intrasellar mass with a small irregular nodule of internal enhancement and a 'figure of 8' configuration. It has superiorly displaced and compressed the chiasm. It does not appear to have invaded the clivus, sphenoid sinus nor cavernous sinuses.
Case Discussion
The patient went on to have transsphenoidal surgery.
Histology
The sections show a cyst lined by a combination of ciliated columnar epithelial cells containing goblet cells and squamous epithelial cells. Separate from the cyst is a solid arrangement of mature squamous epithelium surrounding fibrovascular cores. No mitotic figures or areas of necrosis are identified. The features are of papillary craniopharyngioma.
Final diagnosis: papillary craniopharyngioma
Discussion
This case demonstrates somewhat unusual appearances of a papillary craniopharyngioma. The intrinsic high T1 signal is more typical of adamantinomatous craniopharyngiomas
or necrotic pituitary macroadenomas. This is particularly the case given that the mass appears to have arisen from the pituitary fossa. Similarly, the age of presentation, only 20 years of age, is relatively young for papillary craniopharyngioma.
Unable to process the form. Check for errors and try again.