Clayton Wiley MD/PhD. The patient is a 72-year-old male who presents with bitemporal hemianopsia without endocrine abnormalities. Diagram bitemporal hemianopsia?

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Presentation transcript:

Clayton Wiley MD/PhD

The patient is a 72-year-old male who presents with bitemporal hemianopsia without endocrine abnormalities. Diagram bitemporal hemianopsia? Question 1

Coronal T1

Coronal +Contrast

Sagittal +contrast

What is the differential diagnosis based on MRI/age. Question 2

Suprasellar lesions include: Aneurysm Dermoid/epidermoid cyst Craniopharyngioma Granular cell tumor Hypophysitis Hypothalamic neuronal hamartoma Meningioma Metastasis Optic glioma Pituitary macroadenoma Rathke's cyst Xanthogranuloma Answer

The surgeon performs an endoscopic endonasal biopsy, and an intraoperative evaluation is requested. Describe the cytologic features of the smear. Click here to view slide.here Question 3

The patient undergoes resection. Review the permanent section. Describe the histologic features of this lesion. Click here to view slide.here Question 5

What is your final diagnosis? Question 6

Craniopharyngioma, adamantinomatous-type Answer

What is the corresponding WHO grade of this lesion? Question 8

WHO grade I Answer

How would you expect this material to appear grossly? Question 10

Thick brownish-yellow fluid, like machine oil, possibly with crumbly debris. Answer

From what embryologic structure is this tumor presumed to develop? Question 11

Rathke pouch epithelium Answer