CT head of a 9-year-old girl with bitemporal hemianopia shows a suprasellar mass with peripheral rim calcification and mixed cystic and solid components. MRI confirms a lobulated sellar and suprasellar lesion compressing the optic chiasm. The most likely diagnosis is:

• A Pituitary macroadenoma
• B Rathke cleft cyst
• C Optic pathway glioma
• D Craniopharyngioma ✓

Explanation

Adamantinomatous craniopharyngioma classically presents in children as a suprasellar cystic and solid mass with rim or nodular calcification, compressing the chiasm to cause bitemporal hemianopia. Calcification is the feature that excludes pituitary macroadenoma, which enlarges the sella and rarely calcifies, and Rathke cleft cyst, which is a smooth non-calcified non-enhancing intrasellar cyst.

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.