Transcript Case Study - University of Pittsburgh

Clayton Wiley MD/PhD
Question 1
The patient is a 72-year-old male who presents with bitemporal
hemianopsia without endocrine abnormalities.
Diagram bitemporal hemianopsia?
www.dwp.gov.uk
Coronal T1
Coronal +Contrast
Sagittal +contrast
Question 2
What is the differential diagnosis based on MRI/age.
Answer
Suprasellar lesions
include: Aneurysm Dermoid/epidermoid
cyst Craniopharyngioma Granular cell
tumor Hypophysitis Hypothalamic neuronal
hamartoma Meningioma Metastasis Optic
glioma Pituitary macroadenoma Rathke's
cyst Xanthogranuloma
Question 3
The surgeon performs an endoscopic endonasal biopsy, and
an intraoperative evaluation is requested. Describe the
cytologic features of the smear.
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Question 5
The patient undergoes resection. Review the permanent
section. Describe the histologic features of this lesion.
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Question 6
What is your final diagnosis?
Answer
Craniopharyngioma, adamantinomatous-type
Question 8
What is the corresponding WHO grade of this lesion?
Answer
WHO grade I
Question 10
How would you expect this material to appear grossly?
Answer
Thick brownish-yellow fluid, like machine oil, possibly with
crumbly debris.
Question 11
From what embryologic structure is this tumor presumed to
develop?
Answer
Rathke pouch epithelium