[Computerized tomographic evaluation of 33 cases of craniopharyngioma, with special reference to unusual extension, iso-dense cyst and homogeneous enhancement].
Although craniopharyngiomas are widely known to exhibit three basic CT characteristics; calcification, cyst(s) and contrast enhancement (CE), several cases with atypical CT manifestations have been reported lately. These atypical manifestations can be classified into unusual extensions of the tumors, high dense cyst and marked homogeneous CE. The CT scans obtained in our recent series of 33 craniopharyngiomas were evaluated to analyze tumoral extensions, cyst density and CE. Cystic tumors were much more frequent than solid tumors (Table 1); 13 cases (39%) were exclusively cystic, 15 cases (45%) equally cystic and solid, and 5 case (15%) solid. Calcifications were present in 80% in children and 39% in adults. Unusual extensions were noted in 7 cases (Fig. 2,3,4); anteriorly to the frontal fossa (5 cases, 15%), laterally to the temporal fossa (1 case, 3%) and posteriorly to the posterior fossa (1 case, 3%). All these tumors were either pure cystic or equally cystic and solid. Cystic portions were detected in the tumors of 28 cases (Table 2). Although the majority of the cystic portions (22 cases, 79%) were low density, iso-dense cysts were observed in 6 cases (21%). Out of 20 cases exhibiting solid portions in the tumors, high density areas (calcified masses) were detected in 3 cases and mixed density areas in 17 cases (Table 3). While these 17 cases showed CE, marked homogeneous CE were noted in 5 cases (29%). Since the advent of high resolution computerized tomography, most of typical craniopharyngiomas can be differentiated from other parasellar lesions; pituitary adenoma, meningioma, optic or hypothalamic glioma, aneurysm, dermoid, epidermoid, arachnoid cyst, germinoma and so forth.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging; D002648:Child; D003397:Craniopharyngioma / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed