The patient was taken to surgery and the tumor was biopsied for frozen section and then partially resected. The following image represents the histopathology.
2. The diagnosis of this disease process is:
Craniopharyngioma
A 13 year old male presents with cold intolerance, lethargy and having to urinate
10 to 12 times per day (polyuria). On physical exam he is very short for his
stated age (4’-11") and does not exhibit any pubic, axillary, or facial
hair and has small genitals. He exhibits bilateral papilledema and bitemporal
hemianopsia. There is normal tone and strength andmuscle stretch reflexes are
normal and symetrical. Laboratory values reveals a mildly elevated hemoglobin
(17 gm/dl) and hematocrit (51%), and normal platelet count and WBC count. Electrolytes
are normal except for sodium which is elevated at 153 meq/L. Serum glucose was
104 mg/dl and a urinalysis revealed a specific gravity <1.004 with no protein
or glucose present and normal cell count. Thyroid function studies revealed
a decreased TSH, T3 and T4.
An MRI of the head and neck was preformed represented by the following images.
1. The most likely diagnosis based on the above clinical presentation is:
A. Pituitary adenoma
B. Hypothalamic pilocytic astrocytoma
C. Craniopharyngioma
D. Pleomorphic xanthoastrocytoma
E. Colloid cyst
Correct Answer: C
The patient was taken to surgery and the tumor was biopsied for frozen section and then partially resected. The following image represents the histopathology.
2. The diagnosis of this disease process is:
A. Pituitary adenoma
B. Colloid cyst
C. Hypothalamic pilocytic astrocytoma
D. Craniopharyngioma
E. Pleomorphic xanthoastrocytoma
Correct Answer: D
3. These tumors arise from:
A. Fibrillary astrocytes
B. Remnants of Rathke’s pouch
C. Dysplastic choroid plexus
D. Neurons
E. Microglial cells
Correct Answer: B
4. Tumors of this type arising in adults usually present clinically with:
A. Visual disturbances
B. Acromegaly
C. Hyperthyroidism
D. Chest lesions on x-ray
E. Focal motor seizures
Correct Answer: A
5. Histologically, this tumor is:
A. A malignant epithelial tumor
B. Malignant glial tumor
C. An undifferentiated astrocytoma
D. Benign epithelial tumor
E. A benign glial tumor
Correct Answer: D
6. The following statement(s) is/are true concerning craniopharyngioma:
A. The presence of calcifications on the scans is important in ruling out hypothalamic pilocytic astrocytoma in the differential diagnosis.
B. Patients with these tumors can present with diabetes insipidus, growth retardation, headaches and bitemporal hemianopsia.
C. Surgical partial resection is the usual treatment while needle aspiration with radiation is an alternative treatment.
D. All of the above
E. None of the above
Correct Answer: D