A 45-year-old woman presents with progressive headache, bitemporal hemianopia, and galactorrhoea despite normal prolactin levels. MRI shows a large suprasellar mass with calcification. The most likely diagnosis and the treatment of choice are:
- A Craniopharyngioma; surgical resection (transsphenoidal or transcranial) with radiotherapy for residual disease ✓
- B Prolactinoma; cabergoline
- C Meningioma; surgical excision
- D Optic glioma; radiotherapy alone
Correct answer: A. Craniopharyngioma; surgical resection (transsphenoidal or transcranial) with radiotherapy for residual disease
Explanation
A calcified suprasellar mass with bitemporal hemianopia in a middle-aged woman is classic for craniopharyngioma, which arises from Rathke's pouch remnants and frequently contains calcification ('eggshell' or 'popcorn' pattern on imaging). Treatment is surgical resection (transsphenoidal for smaller infrasellar component; transcranial for large suprasellar extension) followed by adjuvant radiotherapy for residual tumour.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.