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RADIOLOGY: HEAD: Case# 33611: CRANIOPHARYNGIOMA. This 21 old male presented with inability "to see anything off to the side". T1 weighted coronal MRI after gadolinium reveals a cystic mass above the sella with peripheral enhancement. Craniopharyngioma arise from rests of squamous epithelium left following involution of the hypophyseal-Rathkes duct. Most arise in children or young adults, with the peak incidence around ten years of age. In children they account for one half of all suprasellar tumors. On imaging studies they are lobulated cystic masses with mural nodules. Calcification of the rim and/or nodule is seen in most cases. Enhancement of the rim and nodule is also typical. The high signal cyst fluid seen on T1 weighted MR images in some cases is related to high protein content and/or blood breakdown products. Three quarters are entirely suprasellar, with most of the rest being both intra- and suprasellar. Only rarely are craniopharyngioma entirely within the sella.

Peter Anderson
head, radiology