Craniopharyngioma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

The CT findings depend on the subtype of craniopharyngioma. On CT, the adamantinomatous type is characterized by large cysts, vivid enhancement and peripheral calcifications. The papillary type tend to be more spherical in outline and usually lack the prominent cystic component and are mostly solid. Calcification is rare.

CT

Although similar in terms of location, radiographic features depend on the subtype. There is a significant minority of tumors having both adamantinomatous and papillary components that many show overlapping features.[1]

Adamantinomatous

Unenhanced CT shows a calcified cystic structure in the supra sellar region, together with hydrocephalus Source:Wikimedia Commons
  • Cysts
    • Typically large and a dominant feature
    • Near CSF density
  • Solid component
  • Calcification
    • Seen in 90%
    • Typically stippled and often peripheral in location.[3]
    • 85% T1 hypointense

Papillary

Papillary craniopharyngioma tend to be more spherical in outline and usually lack the prominent cystic component; most are either solid or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on CT are:[4]

  • Cysts
    • Small and not a major feature
    • Near CSF density
  • Solid component
    • Soft tissue density
    • Vivid enhancement
  • Calcification
    • Uncommon, rare

References

  1. MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma
  2. DATI T (October 1961). "[Radiology of craniopharyngiomas with special reference to pneumoencephalography. II]". Rass Fisiopatol Clin Ter (in Italian). 33: 955–67. PMID 13883661.
  3. Burrell S, Hebb AL, Imran SA, Mishra A, Mawko G, Clarke DB (March 2017). "Visualization of 90Yttrium Colloid Within a Cystic Craniopharyngioma Using PET/CT/MRI Fusion". Can J Neurol Sci. 44 (2): 192–193. doi:10.1017/cjn.2016.410. PMID 27846921.
  4. Nishioka H, Nagata Y, Fukuhara N, Yamaguchi-Okada M, Yamada S (June 2018). "Endoscopic Endonasal Surgery for Subdiaphragmatic Type Craniopharyngiomas". Neurol. Med. Chir. (Tokyo). 58 (6): 260–265. doi:10.2176/nmc.oa.2018-0028. PMC 6002681. PMID 29877209.


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