Craniopharyngioma CT: Difference between revisions

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{{Craniopharyngioma}}
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==Overview==
==Overview==
The CT findings depend on the subtype of craniopharyngioma. On CT, the adamantinomatous type is characterized by large [[cysts]], vivid enhancement and peripheral calcifications. Papillary type tend to be more spherical in outline and usually lack the prominent cystic component; most are solid. Calcification is rare.
The CT findings depend on the subtype of craniopharyngioma. On CT, the adamantinomatous type is characterized by large [[cysts]], vivid enhancement and peripheral calcifications. Papillary type tend to be more spherical in outline and usually lack the prominent cystic component; most are solid. Calcification is rare.


==CT==
==CT==
Although similar in terms of location, radiographic features depend on the subtype, although due to a significant minority of tumor having both adamantinomatous and papillary components many show overlapping features.
Although similar in terms of location, radiographic features depend on the subtype, although due to a significant minority of tumor having both adamantinomatous and papillary components many show overlapping features.<ref>MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma</ref>


===Adamantinomatous===
===Adamantinomatous===
Adamantinomatous type is the most common form (90%),  and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on CT scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the [[third ventricle]], and encasing vessels, and even being adherent to adjacent structures. The findings on CT are:
Adamantinomatous type is the most common form (90%),  and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on CT scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the [[third ventricle]], and encasing vessels, and even being adherent to adjacent structures. The findings on CT are:<ref name="pmid13883661">{{cite journal |vauthors=DATI T |title=[Radiology of craniopharyngiomas with special reference to pneumoencephalography. II] |language=Italian |journal=Rass Fisiopatol Clin Ter |volume=33 |issue= |pages=955–67 |date=October 1961 |pmid=13883661 |doi= |url=}}</ref>
{| align="right"
{| align="right"
|[[File:CraniopharyngiomaCT.jpg|thumb|none|300px| Unenhanced CT shows a calcified cystic structure in the supra sellar region, together with hydrocephalus [https://upload.wikimedia.org/wikipedia/commons/a/aa/Craniopharyngioma1.jpg Source:Wikimedia Commons] ]]
|[[File:CraniopharyngiomaCT.jpg|thumb|none|300px| Unenhanced CT shows a calcified cystic structure in the supra sellar region, together with hydrocephalus [https://upload.wikimedia.org/wikipedia/commons/a/aa/Craniopharyngioma1.jpg Source:Wikimedia Commons] ]]
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*'''Calcification'''
*'''Calcification'''
**Seen in 90%
**Seen in 90%
**Typically stippled and often peripheral in location
**Typically stippled and often peripheral in location.<ref name="pmid27846921">{{cite journal |vauthors=Burrell S, Hebb AL, Imran SA, Mishra A, Mawko G, Clarke DB |title=Visualization of 90Yttrium Colloid Within a Cystic Craniopharyngioma Using PET/CT/MRI Fusion |journal=Can J Neurol Sci |volume=44 |issue=2 |pages=192–193 |date=March 2017 |pmid=27846921 |doi=10.1017/cjn.2016.410 |url=}}</ref>
**85% T1 hypointense


===Papillary===
===Papillary===
Papillary craniopharyngioma tend to be more ''spherical'' in outline and usually lack the prominent cystic component; most are either ''solid'' or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on CT are:
Papillary craniopharyngioma tend to be more ''spherical'' in outline and usually lack the prominent cystic component; most are either ''solid'' or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on CT are:<ref name="pmid29877209">{{cite journal |vauthors=Nishioka H, Nagata Y, Fukuhara N, Yamaguchi-Okada M, Yamada S |title=Endoscopic Endonasal Surgery for Subdiaphragmatic Type Craniopharyngiomas |journal=Neurol. Med. Chir. (Tokyo) |volume=58 |issue=6 |pages=260–265 |date=June 2018 |pmid=29877209 |pmc=6002681 |doi=10.2176/nmc.oa.2018-0028 |url=}}</ref>
*'''Cysts'''
*'''Cysts'''
**Small and not a major feature
**Small and not a major feature

Revision as of 15:51, 14 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

The CT findings depend on the subtype of craniopharyngioma. On CT, the adamantinomatous type is characterized by large cysts, vivid enhancement and peripheral calcifications. Papillary type tend to be more spherical in outline and usually lack the prominent cystic component; most are solid. Calcification is rare.

CT

Although similar in terms of location, radiographic features depend on the subtype, although due to a significant minority of tumor having both adamantinomatous and papillary components many show overlapping features.[1]

Adamantinomatous

Adamantinomatous type is the most common form (90%), and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on CT scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the third ventricle, and encasing vessels, and even being adherent to adjacent structures. The findings on CT are:[2]

Unenhanced CT shows a calcified cystic structure in the supra sellar region, together with hydrocephalus Source:Wikimedia Commons
  • Cysts
    • Typically large and a dominant feature
    • Near CSF density
  • Solid component
    • Soft tissue density
    • Enhancement in 90%
  • Calcification
    • Seen in 90%
    • Typically stippled and often peripheral in location.[3]
    • 85% T1 hypointense

Papillary

Papillary craniopharyngioma tend to be more spherical in outline and usually lack the prominent cystic component; most are either solid or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on CT are:[4]

  • Cysts
    • Small and not a major feature
    • Near CSF density
  • Solid component
    • Soft tissue density
    • Vivid enhancement
  • Calcification
    • Uncommon, rare

References

  1. MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma
  2. DATI T (October 1961). "[Radiology of craniopharyngiomas with special reference to pneumoencephalography. II]". Rass Fisiopatol Clin Ter (in Italian). 33: 955–67. PMID 13883661.
  3. Burrell S, Hebb AL, Imran SA, Mishra A, Mawko G, Clarke DB (March 2017). "Visualization of 90Yttrium Colloid Within a Cystic Craniopharyngioma Using PET/CT/MRI Fusion". Can J Neurol Sci. 44 (2): 192–193. doi:10.1017/cjn.2016.410. PMID 27846921.
  4. Nishioka H, Nagata Y, Fukuhara N, Yamaguchi-Okada M, Yamada S (June 2018). "Endoscopic Endonasal Surgery for Subdiaphragmatic Type Craniopharyngiomas". Neurol. Med. Chir. (Tokyo). 58 (6): 260–265. doi:10.2176/nmc.oa.2018-0028. PMC 6002681. PMID 29877209.


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