Craniopharyngioma - Case 2
A 51 year-old man presented with severe nausea. While in the hospital, he was noted to have episodes of shaking of the arms and would not respond to verbal stimuli. An urgent head CT scan was ordered, followed by emergency neurosurgical intervention and a subsequent MRI scan.


          Note the Suprasellar Mass     Note the Gadolinium Enhancement     Note the Involvement of the Infundibulum

Craniopharyngioma. (Left) T1-weighted with gadolinium axial MRI; (Middle) T1-weighted with gadolinium coronal MRI; (Right) T1-weighted with gadolinium sagittal MRI;. Note the presence of a large suprasellar mass that enhances with gadolinium. If one looks closely, one can see the thickening and greater enhancement of the mass near the infundibulum of the pituitary. Surgical removal demonstrated a craniopharyngioma.

Craniopharyngiomas arise in the suprasellar region and are often calcified and cystic. They are slow growing tumors that occur in children and adults, and can become very large in size. In children, they are thought to occur as a result of impaired embryogenesis of structures in or near the infundibulum of the pituitary gland. In adults, they are believed to occur as a result of metaplasia of pituitary squamous epithelium. Similar to pituitary macroadenomas, they may present with endocrine dysfunction or focal neurological signs due to mass effect in the suprasellar region.

Revised 11/28/06.
Copyrighted 2006. David C Preston