ADAMANTINOMATOUS CRANIOPHARYNGIOMA MISTAKEN AS RATHKE’S CLEFT CYST: A CASE REPORT

Abstract

When a suprasellar mass is encountered, the differential diagnosis is crucial in order for the operating surgeon to determine further management and surgical approach.  However, it is not always easy if the mass exhibits mixed solid cystic or entirely cystic features. The author presents a case of a 19-year-old lady who initially presented with left facial weakness, subsequently has been followed up several years for Rathke’s cleft cyst (RCC) in view of its MR appearance. But recently the patient complained of eye symptoms, occipital headache and amenorrhea. Repeat MRI showed increasing size of the suprasellar mass and local mass effect unto the optic chiasm. Patient underwent deroofing of the cyst with the histopathological examination which revealed adamantinomatous craniopharyngioma. Nevertheless, possible transformation of RCC into craniopharyngioma is not known in view of no tissue diagnosis was obtained earlier on. Review of MR appearances of these two entities in previous literature as well as the radiopathological correlation and differentiating features are presented.

Acknowledgement: Radiology Department, Sultan Ahmad Shah Medical Centre (SASMEC)