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Fetal MRI at 28 Hbd. Solid tumor with cystic elements in the midline and in the right hemisphere, without edema. The mass effect on the right lateral ventricle, IIIrd ventricle and pons is seen. SSFSE/T2, sagittal plane (A), transverse (B) and coronal (C). FGRE/T1, transverse plane - no signal intensity typical for fatty tissue (D).
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Due to the location and morphology of the lesion, a diagnosis of craniopharyngioma was suggested (Figure 1A-D).
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MRI of the newborn at the first day of life. SE/T1, transverse plane (A), (B) Solid-cystic tumor. Solid part of the tumor is in the midline, cystic part is seen laterally. Lateral ventricles are dilated (A). Scan on the level of the solid part, the midbrain is pushed posteriorly, cerebral peduncles are splayed (B).
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It was occupying the suprasellar region and was protruding into the III ventricle (Figure 2A,B).
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MR at the age of 4 weeks. Progression of the tumour. SET1, transverse plane (A), (B), TSET2, sagittal plane (C), SET1+gad, sagittal plane (D). Enlargement of the cystic part of the tumour with widened lateral ventricles (A). Slight enlargement of the solid part of the mass, with large occipital horns of the lateral ventricles (B). The midline scan, heterogenous tumour in the sellar/suprasellar region, extending posteriorly into the interpeduncular cistern and distorting the midbrain (C). Strong enhancement of the solid mass and thin rim of enhancement of the cystic part (D).
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The tumour measured 55x45x63 mm in its solid part, and 44x42x49 mm in its cystic part (Figure 3A-D).
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Histopathologic examination. Craniopharyngioma, adamantinomatous type. (A) Epithelial cells with characteristic peripheral palisading. HE (x40). (B) Epithelial cells with peripheral palisading and loose component so-called stellate reticulum. HE (x100). (C) Keratinized neoplastic cells and foci of calicification. HE(x100).
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The whole macro- and microscopic picture allowed for diagnosing Craniopharyngioma, adamantinomatous type. (Figure 4A-C).
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