Nasal craniopharyngioma: case report and literature review.
OBJECTIVE
We report the first case in the English language literature of an adamantinomatous infrasellar craniopharyngioma, and we describe our management strategy.


METHODS
A 46-year-old woman presented with a six-month history of left-sided nasal obstruction and epistaxis. Rhinological examination revealed a left-sided, polypoidal lesion lying medial to the middle turbinate. An urgent examination under anaesthesia was organised; biopsies were considered characteristic of craniopharyngioma. Magnetic resonance imaging and computed tomography demonstrated a well defined, heterogeneous, infrasellar mass centred in the midline, extending anteriorly into the left nasal cavity and posteriorly encasing both internal carotid arteries. Craniofacial resection was performed via a midfacial degloving approach, with adjuvant radiotherapy. The patient was disease-free one year post-operatively.


CONCLUSIONS
Craniopharyngiomas should be considered in the differential diagnosis of a unilateral nasal polyp. Although technically benign, they are locally aggressive. Therefore, we recommend complete excision with adjuvant radiotherapy if margins are involved or close.
Department of Otolaryngology - Head and Neck Surgery, Charing Cross Hospital, London, UK.
J C
JC
Magill
M S
MS
Ferguson
A
A
Sandison
P M
PM
Clarke
D001706:Biopsy; D003397:Craniopharyngioma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D004844:Epistaxis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology; D015508:Nasal Obstruction / Q000209:etiology; D009298:Nasal Polyps / Q000175:diagnosis; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012658:Sella Turcica; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome