Craniopharyngioma

Diagnosis
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  • Craniopharyngioma is a slow-growing, rare, histologically benign brain tumor affecting children between the ages of 5 and 14 and older adults

  • It is extra-axial, arises near the pituitary gland, and commonly contains solid and cystic components

  • Pressure on the pituitary gland and optic nerves produces headache, visual symptoms and endocrine abnormalities

  • The most common type, adamantinomatous, is seen predominantly in children

  • The tumor often contains single or multiple cysts filled with thick oily fluid rich in protein, blood products, and/or cholesterol, giving the so-called “motor oil” fluid appearance

  • Solid components are variable in intensity on T1 and T2 imaging and enhance vividly on T1 imaging with contrast

  • Cysts are variable in signal on T1 imaging due to high protein content and blood products, and variable but usually hyperintense on T2 imaging

  • Large tumors often compress the midbrain, causing obstructive hydrocephalus

  • Appoximately 90% of craniopharyngiomas have calcifications, 90% have cysts, 90% enhance, and 90% are suprasellar

  • CT scanning is preferred over MRI for showing calcification in the tumor

  1. Plaza MJ, Borja MJ, Altman N, Saigal G. Review. Conventional and advanced MRI features of pediatric intracranial tumors: posterior fossa and suprasellar tumors. AJR 2013; 200:1115-1124