Listed are the pathologies that closely resemble each other, and these pathologies are the favourite questions in final FRCR part A exam.
SELLAR/SUPRA-SELLAR TUMORS
Craniopharyngioma
|
Rathke’s pouch cyst
| |
1
|
Supra-sellar mass
|
Intra-/Supra-sellar lesion
Between the anterior & posterior pituitary lobes
|
2
|
Solid with cystic component
|
Midline cyst, kidney shape on axial
|
3
|
90% with Calcification
|
Seldom Calcification (10-15%), curvilinear
|
4
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75% bony destruction
+/- pseudo fluid-fluid level |
Can compress pituitary gland
|
5
|
90% heterogeneous enhancement
|
Homogeneous, non-enhancing
Occasional rim-like enhancement
|
6
|
↑T2; ↓/↑ T1
Calcification ↓T1
Cyst not suppressed on FLAIR
|
↓T2; ↓/↑T1 (depend on protein content)
|
Clinical features
| ||
7
|
Benign
| |
8
|
Bitemporal hemianopia
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Visual disturbance
|
9
|
Endocrine abnormality: Diabetes insipidus
|
Endocrine abnormality: Hypopituitarism
|
10
|
Bimodal age:
l 5-15yo (most common paediatric suprasellar mass)
l above 50years old
| |
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