Radiological features of craniopharyngiomas located in the posterior fossa.
OBJECTIVE
Posterior fossa craniopharyngiomas (PFCP) constitute 1.6-4% of all craniopharyngiomas and have long been neglected. The purpose of our study was to investigate neuroimaging features of this unique modality in a cohort of 7 cases.


METHODS
CT and/or MR imaging features (with and without contrast enhancement) of 7 patients who underwent craniotomies for histologically proved PFCP were reviewed and analyzed retrospectively. Surgical management was also reviewed.


RESULTS
All PFCPs arised from sellar/suprasellar region and extended into unilateral cerebellopontine angle in 6 cases, and bilateral in 1 case. Seven tumors were of retrochiasmatic origin and 5 of 7 were of retrostalk growth pattern with location in the ventral area of brain stem. On CT scans, tumors were isodense in solid component and hypodense in cystic component with (4/7) or without calcification (3 /7) and destruction in sellae turcia (2/7). Tumors demonstrated cyst formation (7/7) with hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging in 5 cases, hyperintense both on T1- and T2-weighted imaging in 2 cases. The solid components and capsule revealed mild to moderate inhomogeneous enhancement after administration of contrast agents. Total tumor removal was accomplished in 5 cases, subtotal removal and partial removal in 1 case respectively.


CONCLUSIONS
PFCPs are well demarcated, contrast-enhanced tumors, typically with cystic parts or purely cyst. Most of PFCPs demonstrate a retrostalk growth pattern and characteristic connection. Tumor with cystic component arises from sellar region and then extends to posterior fossa, which should be strongly suspected as a PFCP. The combined supra- and infratentorial approach is an ideal choice for surgical management of PFCP.
Zhou
Liangxue
L
State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Li
Qiang
Q
Luo
Linli
L
Xu
Jianguo
J
Zhang
Yuekang
Y
Chen
Tianwu
T
Wei
Yuquan
Y
You
Chao
C
D000293:Adolescent; D000328:Adult; D020863:Central Nervous System Cysts / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D002648:Child; D015331:Cohort Studies; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003397:Craniopharyngioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015192:Infratentorial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome