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Craniopharyngioma — SCE Neurology MCQ

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HardNeuro-oncologyCraniopharyngiomaSCE Neurology

Which radiological pattern most strongly supports an adamantinomatous rather than a papillary craniopharyngioma?

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Correct answer: B — A mixed cystic–solid suprasellar lesion with calcification demonstrated on CT

Adamantinomatous craniopharyngiomas are characteristically mixed cystic–solid lesions and commonly calcify, for which CT is particularly sensitive. Adult papillary craniopharyngiomas are more often solid or mixed but typically do not calcify. Therefore a calcified mixed lesion shifts probability toward the adamantinomatous subtype. A purely cystic pars intermedia lesion suggests a Rathke cleft cyst; homogeneous sellar expansion suggests a macroadenoma; and a dural tail favours meningioma. Histology and molecular testing ultimately establish subtype.

Reference: Endotext: Radiology of the Pituitary. https://www.ncbi.nlm.nih.gov/sites/books/NBK279161/