A 12-year-old boy presents with headaches, visual field defect, and growth failure. CT reveals a suprasellar calcified cystic mass. Histology shows nests of squamous epithelium with peripheral palisading of nuclei, wet keratin nodules, and cholesterol clefts. Which is the diagnosis?

• A Adamantinomatous craniopharyngioma ✓
• B Pituitary adenoma
• C Papillary craniopharyngioma
• D Rathke cleft cyst

Explanation

Adamantinomatous craniopharyngioma is the childhood type, typically suprasellar with calcification. Histology shows nests of squamous epithelium with peripheral nuclear palisading, wet keratin (eosinophilic nodules), and cholesterol clefts. It is driven by CTNNB1 (beta-catenin) mutations. Papillary craniopharyngioma occurs in adults, lacks calcification and wet keratin, and harbors BRAF V600E mutations. Rathke cleft cyst lacks squamous epithelium and calcification.

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.