PMC5223766_01
Brain magnetic resonance imaging before the first surgery, showing a suprasellar mass lesion with enhanced solid and multiseptated cystic components. A : Axial. B : Coronal. C : Sagittal.
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Brain magnetic resonance imaging (MRI) revealed a suprasellar mass lesion with enhanced solid and multiseptated cystic components measuring 3.0x2.8 cm (Fig. 1).
The first biopsy showing a typical adamantinomatous craniopharyngioma.
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Histopathological examination revealed a typical adamantinomatous craniopharyngioma (Fig. 2).
Post-operative magnetic resonance imaging scan obtained 6 months after the first surgery, showing a small residual enhancing mass along the right anterior margin of the floor of the third ventricle. A : Axial. B : Coronal. C : Sagittal.
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After 6 months, MRI showed a residual mass enhanced along the right anterior margin of the third ventricle floor (Fig. 3).
Follow-up brain magnetic resonance imaging 2 years after the first surgery, showing recurrence of multiseptated huge cystic mass in the suprasellar, third, and lateral ventricles. A : Axial. B : Coronal. C : Sagittal.
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MRI showed a recurrence of a multiseptated cystic mass measuring 4.7x5.0 cm in the suprasellar cistern, third ventricle, and parts of the lateral ventricles (Fig. 4).
Histopathologic findings of a specimen obtained during the second surgery. Typical adamantinomatous craniopharyngioma that is highly cellular and presents with a spindled pattern (A, B; hematoxylin-eosin). The immunological tests showing overexpression of p53 (C) and Ki67 (D), and positive results for pancytokeratin (E) and vimentin (F).
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The tumor was highly cellular and presented with a spindled pattern (Fig. 5A, B). Immunological tests showed overexpression of p53 and Ki67 (Ki67 labeling index 15%) (Fig. 5C, D), and the tumor cells were positive for pancytokeratin and vimentin (Fig. 5E, F).
Brain magnetic resonance imaging after the second surgery showing total resection of the recurrent mass. A : Axial. B : Coronal. C : Sagittal.
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After three months, MRI showed no residual tumor (Fig. 6).