A 7-year-old boy presents with growth retardation and bitemporal visual field defects. CT shows a suprasellar mass with coarse calcification. Histology shows nests of squamous epithelium with peripheral palisading, wet keratin, and calcification. The most likely diagnosis is:

• A Pituitary adenoma
• B Optic pathway glioma
• C Rathke cleft cyst
• D Craniopharyngioma, adamantinomatous type ✓

Explanation

Adamantinomatous craniopharyngioma occurs in children, arises from remnants of Rathke pouch above the sella, and shows squamous nests with peripheral palisading, stellate reticulum, wet keratin (ghost cells), and calcification visible on CT. It compresses the optic chiasm causing bitemporal hemianopia and disrupts hypothalamic-pituitary function. Papillary craniopharyngioma is the adult variant and lacks wet keratin and calcification. Pituitary adenoma rarely calcifies.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.