Clayton Wiley MD/PhD

The patient is a 72-year-old male who presents with bitemporal hemianopsia without endocrine abnormalities. 

Diagram bitemporal hemianopsia?

Question 1

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Coronal T1

Coronal +Contrast

Sagittal +contrast

What is the differential diagnosis based on MRI/age.

Question 2

Suprasellar lesions include:AneurysmDermoid/epidermoid cystCraniopharyngiomaGranular cell tumorHypophysitisHypothalamic neuronal hamartomaMeningiomaMetastasisOptic gliomaPituitary macroadenomaRathke's cystXanthogranuloma

Answer

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 3

The patient undergoes resection.  Review the permanent section.  Describe the histologic features of this lesion.

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Question 5

What is your final diagnosis?

Question 6

Craniopharyngioma, adamantinomatous-type

Answer

What is the corresponding WHO grade of this lesion?

Question 8

WHO grade I

Answer

How would you expect this material to appear grossly?

Question 10

Thick brownish-yellow fluid, like machine oil, possibly with crumbly debris.

Answer

From what embryologic structure is this tumor presumed to develop?

Question 11

Rathke pouch epithelium

Answer