A 30-year-old woman presents with progressive headaches, papilloedema, and bitemporal hemianopia. MRI pituitary shows a 3 cm suprasellar mass with calcification and signal heterogeneity. What is the MOST likely diagnosis?

• A Pituitary macroadenoma
• B Craniopharyngioma ✓
• C Meningioma of the tuberculum sellae
• D Rathke's cleft cyst

Explanation

Craniopharyngioma is an epithelial tumour arising from remnants of Rathke's pouch. The classic triad of presentation is visual field defects (bitemporal hemianopia from optic chiasm compression), raised intracranial pressure, and hypopituitarism. Imaging characteristically shows a cystic suprasellar mass with calcification (in >90% of adamantinomatous type) on CT. The adamantinomatous subtype predominates in children, while the papillary type is more common in adults. Pituitary adenomas are typically soft tissue without calcification; Rathke's cleft cysts are non-enhancing midline cysts.

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.