A 10-year-old boy presents with headaches, visual disturbance, and growth failure. MRI shows a suprasellar calcified cystic mass with a solid enhancing component. Histology shows palisading epithelium with wet keratin and calcification. What is the most likely diagnosis?

• A Craniopharyngioma (adamantinomatous type) ✓
• B Pituitary macroadenoma
• C Germinoma
• D Rathke's cleft cyst

Explanation

Craniopharyngioma, adamantinomatous type, is the most common suprasellar tumor in children and classically presents with calcification on imaging, cystic 'motor oil' fluid, and histology showing palisading squamous epithelium with wet keratin nodules and calcification. BRAF V600E mutations are characteristic. Pituitary adenomas rarely calcify. Germinoma is usually homogeneous and enhances vividly. Rathke's cleft cyst lacks calcification and solid components.

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.