A 6-year-old child presents with a cystic sellar/suprasellar mass causing bitemporal hemianopia, short stature, and diabetes insipidus. Biopsy shows a tumor with a peripheral layer of palisading columnar epithelium, central stellate reticulum, and areas of wet keratin (compact squamous epithelium with ghost cells). This is most consistent with:

• A Craniopharyngioma (adamantinomatous type) ✓
• B Germinoma
• C Pituitary adenoma
• D Rathke cleft cyst

Explanation

Craniopharyngioma is a benign but locally aggressive tumor arising from Rathke pouch remnants in the sellar and suprasellar region. The adamantinomatous variant (more common in children) shows palisading peripheral epithelium, stellate reticulum, and pathognomonic 'wet keratin' (nodules of ghost cells with dystrophic calcification). Its location causes hypothalamic-pituitary dysfunction, visual field defects, and hydrocephalus. The papillary variant is more common in adults and lacks wet keratin.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.