Concluded Case

Craniopharyngioma with obstructive hydrocephalus

41 yr ,F, presented with progressive visual impairment since 2 yrs. Denied having any significant head ache/ vomiting / motor or sensory symptoms. For the visual impairment she was investigated in another hospital and VP shunt was done and was suggested surgery.Instead of going to the previous hospital ,she came for further management. She is on eltroxin for 5 yrs ,50 mcg daily.No other significant past medical illness. She is the mother of 2 children. Examination : BP 130/ 80 mmhg . Optic fundi were normal . Bitemporal field deficit. Intact other cranial nerves.No long tract signs. Normal gait. What abnormality in the MRI brain ? What is the diagnosis?

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Concluded answer

Thanks for the answers. MRI brain shows well defined lobulated mass lesion involving the suprasellar,sellar region with multiple cystic area with intervening solid components showing intense heterogeneous post contrast enhancement with areas of calcification and mass effect with resulting obstructive hydrocephalus. Imp : CRANIOPHARYNGIOMA. Surgery done.Pt is better. Needs post surgical radiotherapy

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Thanks for the answers. MRI brain shows well defined lobulated mass lesion involving the suprasellar,sellar region with multiple cystic area with intervening solid components showing intense heterogeneous post contrast enhancement with areas of calcification and mass effect with resulting obstructive hydrocephalus. Imp : CRANIOPHARYNGIOMA. Surgery done.Pt is better. Needs post surgical radiotherapy

why radiotherapy mam?
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This is really a big mass at midline compressing the optic chiasma and adjacent structure causing non communicating hydrocephalus with large lateral ventricles with rt sided vp shunt in situ. Mass is relatively homogenous with well definite margins with central hypo s/o necrosis 1st possibility of pituitary macroadenoma, 2nd craniopharyngoma 3r meningioma

Seller pit adenoma. With hydrocephalus with shunt in situ

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