Craniopharyngioma Quick review - Pathology USMLE Step 1

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06/28/23

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Craniopharyngioma
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A brain tumor arising from pituitary embryonic tissue. It is typically suprasellar and has solid and cystic components. Age of onset can occur in childhood (about age 10-15) or adulthood (about age 50-70). There are adamantinomatous, papillary, and mixed types. Adamantinomatous tumors are more common in children and papillary tumors are more common in adults. It is usually slow growing, and symptoms arise from compression of surrounding structures or increased intracranial pressure. Presenting symptoms include visual loss (most commonly superior temporal quadrantanopsia), headache, hormonal imbalances leading to delayed puberty in children, amenorrhea, hypersomnia, diabetes insipidus, and/or decreased libido. These tumors are usually benign with good prognosis, but often recur after incomplete resection.

Best Tests
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Head CT may show a solid and cystic mass, which can be bright in some types due to calcification.

Brain MRI with and without gadolinium typically shows a suprasellar cystic lesion that enhances with contrast.

Biopsy, usually done with tumor resection, confirms the diagnosis.