Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Cervical Transverse Process Fracture
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Case History


Teenager with headache and visual disturbance.


Case Detail

Anatomy: Brain
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 8 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: MR CT
Activities:
Adobe32 PDF Imagej32 ImageJA

Case Images


Academic Case Revealer (Click to Expand)

Reveal Findings

MRI – Sagittal T1, T2 and post gadolinium T1 and Axial T2 and GRE images demonstrate a macrolobulated cystic intrasellar and suprasellar mass with fluid-fluid or fluid-debris levels.

CT – Subtle solid component with calcification is seen with wide W/L setting near the posterior right clinoid process.

Reveal Discussion

Craniopharyngiomas are tumors arising from remnants of the craniopharyngeal duct anywhere in the midline from the sphenoid sinus to the sella tursica to the third ventricle. Patients usually present during adolescence but a second peak occurs during the fourth through sixth decades (the lesions tend to be suprasellar in children and intrasellar in adults). Craniopharyngiomas are more common in males. Symptoms include headache and visual changes as in this patient but also hypothalamic-pituitary dysfunction and hydrocephalus can be encountered.

Craniopharyngiomas usually have solid and cystic components but may be predominantly solid or cystic. Size of these lesions varies but larger lesions are usually cystic. Calcification in the cyst wall or solid component is common and aids in the diagnosis of craniopharyngioma. Cyst fluid is rich in cholesterol crystals.

Calcification of the small solid component in this case make the diagnosis difficult. Consequently, epidermoid cyst, arachnoid cyst and juvenile pilocytic astrocytoma could be considered in the differential diagnosis.

Reveal Diagnosis

Cystic craniopharyngioma.

Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare