case_images: PMC7495153_01
case_images: Initial MRI without gadolinium ordered by primary care provider, revealing a suprasellar mass extending into the anterior portion of the third ventricle and displacing the hypothalamus. There is evidence of a robust septal flap and residual fat graft from prior resection.
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case_images: PMC7495153_01_CRIOT2020-9584090.001.jpg
case_images: fig1
case_images: An MRI without gadolinium revealed a heterogeneous 3 cm suprasellar mass extending into the third ventricle, with superior displacement of the hypothalamus and optic chiasm (Figure 1).
case_images: CT with contrast obtained by neurosurgery and otolaryngologist the day before surgery revealing a 2.7 cm x 2.3 cm x 1.9 cm suprasellar mass with peripheral calcifications. The mass impinges on the foramen of Monro and the anterior portion of the third ventricles.
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case_images: fig2
case_images: T4. Thereafter, the patient received a CT scan prior to surgery revealing the tumor invading into the third ventricle (Figure 2).
case_images: Histological examination revealing collision tumor transition point. The center of the image reveals pituitary adenoma tissue with elongated cells in a pseudorosette pattern. The surrounding tissue reveals the adamantinomatous craniopharyngioma with whorls of keratin and stellate reticulum.
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case_images: PMC7495153_01_CRIOT2020-9584090.003.jpg
case_images: fig3
case_images: Subsequent histopathological examination of the surgical specimen revealed two tumor components within the resection: adamantinomatous craniopharyngioma and hypercellular recurrent pituitary adenoma (Figure 3).
case_images: This histological section reveals a higher powered magnification of Figure 3 demonstrating the pituitary adenoma with elongated cells in a pseudorosette pattern.
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case_images: PMC7495153_01_CRIOT2020-9584090.004.jpg
case_images: fig4
case_images: The pituitary adenoma portion revealed elongated cells in a pseudorosette pattern which was expected for this type of tumor (Figure 4).
case_images: This section reveals stellate reticulum in the middle of the image with whorls of keratin diffusely throughout consistent with the adamantinomatous craniopharyngioma.
case_images: CRIOT2020-9584090.005.jpg
case_images: PMC7495153_01_CRIOT2020-9584090.005.jpg
case_images: fig5
case_images: Histology of the adamantinomatous craniopharyngioma revealed stellate reticulum with whorls of keratin (Figure 5).