Craniopharyngioma arising in a Rathke's cleft cyst: Case report

Ahmed K. Alomari, Brian J. Kelley, Eyiyemisi Damisah, Asher Marks, Pei Hui, Michael DiLuna, Alexander Vortmeyer

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Craniopharyngioma is one of the most common non-glial intracranial tumors of childhood. Its relation to Rathke's cleft cyst (RCC) is controversial, and both lesions have been hypothesized to lie on a continuum of cystic ectodermal lesions of the sellar region. The authors report on a 7-year-old boy who presented with decreased visual acuity, presumably of at least 2 years' duration, and was found to have a 5.2-cm sellar lesion with rim enhancement. Histological examination of the resected lesion showed a mixture of areas with simple RCC morphology with focal squamous metaplasia and areas with typical craniopharyngioma morphology. Immunohistochemical staining with CK20 and Ki 67 differentially highlighted the 2 morphological components. Testing for beta-catenin and BRAF mutations was negative in the craniopharyngioma component, precluding definitive molecular classification. Follow-up imaging showed minimal residual enhancement and the patient will be closely followed up with serial MRI. Given the clinical and histological findings in the case, a progressive transformation of the RCC to craniopharyngioma seems to be the most plausible explanation for the co-occurrence of the 2 lesion types in this patient. An extensive review of previously proposed theories of the relationship between craniopharyngioma and RCC is also presented.

Original languageEnglish (US)
Pages (from-to)250-254
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume15
Issue number3
DOIs
StatePublished - Mar 2015

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Keywords

  • BRAF
  • Beta-catenin
  • Craniopharyngioma
  • Oncology
  • Rathke's cleft cyst

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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