Craniopharyngioma is a benign epithelial tumor
that originates from the Rathke pouch and usually develops around the
parasellarregion. By pathology the tumor is divided into two main types, the
adamantinomatous type and squamous papillary type. In contrast to the usual
parasellar location, primary craniopharyngioma developing in the
Cerebellopontine (CP) angle is extremely rare, with only eleven cases reported
to date. Ten of these cases were of the adamantinomatous type and one was
of the squamous papillary type. Here, we report the neuroradiological
findings from two additional cases of squamous papillary-type craniopharyngioma
that developed in the CP angle and were isolated from the parasellar region.
The patient was therefore operated on via a lateral sub
occipital approach. A cystic tumor was identified, with a rust-colored
component being visible through the wall of the capsule. Following the opening
of the cyst a motor oil-like fluid and semisolid component were drained. The 3rd nerve
and pituitary stalk were identified beyond the arachnoid membrane with neither
showing any sign of contact with the tumor (Figure 1e).
Postoperative MRI revealed near-total
resection of the tumor (Figure 1f). Neuropathology showed that the wall of the
cyst was composed of squamous epithelium with a papillary structure (Figure
1g). In contrast, the tumor contained keratinous material, cholesterin crystal
and a fibrous inflammatory granuloma (Figure 1h), and was diagnosed as a
squamous papillary-type craniopharyngioma. Postoperatively, the patient’s
hearing acuity, facial numbness and gait disturbance improved. No sign of
recurrence has been observed on follow-up examination for six years.
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