Craniopharyngioma, adamantinomatous

12-year-old male with chronic headaches and new onset diabetes insipidus. There is a circumscribed centrally cystic lesion arising from the anterior surface of the infindibulum. The central cystic component demonstrates signal intensity slightly greater than the surrounding CSF space on the T1-weighted image. There is FLAIR hemorrhage/proteinaceous fluid centrally. The high-resolution fluid sensitive sequences demonstrate a lesion with a thin margin abutting the posterior and inferior aspect of the optic chiasm with slight displacement and deformity. The lesion demonstrates a thin enhancing margin. The general differential includes adamantinomatous craniopharyngioma, Rathke’s cleft cyst, and infindibular cyst. This is an adamantinomatous craniopharyngioma. Craniopharyngioma are though to arise via two mechanisms: as remnants of the craniopharyngeal duct, while the second is from squamous epithelial cells in the pars tuberalis of the adenohypophysis. 75% of the adamantinomatous subtype tend to be in the suprasellar compartment. NMR182

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