eMedicine Specialties > Neurology > Neuro-oncology

Craniopharyngioma: Multimedia

Author: George C Bobustuc, MD, Consulting Staff, Department of Neuro-Oncology, MD Anderson Cancer Center Orlando
Coauthor(s): Morris D Groves, MD, Assistant Professor, Department of Neuro-Oncology, MD Anderson Cancer Center, University of Texas; Gregory N Fuller, MD, PhD, Professor of Pathology, Chief, Section of Neuropathology, Department of Pathology, Division of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center; Franco DeMonte, MD, FRCSC, FACS, Professor of Neurosurgery, Mary Beth Pawelek Chair in Neurosurgery, The University of Texas, MD Anderson Cancer Center, Houston Texas
Contributor Information and Disclosures

Updated: Sep 4, 2009

Multimedia

The adamantinomatous craniopharyngioma is a histo...
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Media file 1: The adamantinomatous craniopharyngioma is a histologically complex epithelial lesion with several very distinctive morphologic features. Each of these features is shown under higher power in Images 2-5 (hematoxylin-eosin, x40).
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The adamantinomatous craniopharyngioma is a histo...

The adamantinomatous craniopharyngioma is a histologically complex epithelial lesion with several very distinctive morphologic features. Each of these features is shown under higher power in Images 2-5 (hematoxylin-eosin, x40).

Adamantinomatous craniopharyngiomas. Peripheral p...
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Media file 2: Adamantinomatous craniopharyngiomas. Peripheral palisading of the epithelium is a pronounced feature (hematoxylin-eosin, x100).
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Adamantinomatous craniopharyngiomas. Peripheral p...

Adamantinomatous craniopharyngiomas. Peripheral palisading of the epithelium is a pronounced feature (hematoxylin-eosin, x100).

Adamantinomatous craniopharyngiomas. Frequently, ...
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Media file 3: Adamantinomatous craniopharyngiomas. Frequently, the inner epithelium beneath the superficial palisade undergoes hydropic vacuolization and is referred to as the stellate reticulum (hematoxylin-eosin, x100).
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Adamantinomatous craniopharyngiomas. Frequently, ...

Adamantinomatous craniopharyngiomas. Frequently, the inner epithelium beneath the superficial palisade undergoes hydropic vacuolization and is referred to as the stellate reticulum (hematoxylin-eosin, x100).

Adamantinomatous craniopharyngiomas. Another dist...
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Media file 4: Adamantinomatous craniopharyngiomas. Another distinctive feature of the adamantinomatous variant is scattered nodules of keratin. These nodules are referred to as "wet" keratin because of the plump appearance of the keratinocytes; this is in contrast to the flat, flaky keratin seen in epidermoid and dermoid cysts (hematoxylin-eosin, x100).
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Adamantinomatous craniopharyngiomas. Another dist...

Adamantinomatous craniopharyngiomas. Another distinctive feature of the adamantinomatous variant is scattered nodules of keratin. These nodules are referred to as "wet" keratin because of the plump appearance of the keratinocytes; this is in contrast to the flat, flaky keratin seen in epidermoid and dermoid cysts (hematoxylin-eosin, x100).

Adamantinomatous craniopharyngiomas. Nodules of "...
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Media file 5: Adamantinomatous craniopharyngiomas. Nodules of "wet" keratin frequently calcify; in aggregate, this calcification often can be detected on CT scans, and is a recognized radiologic feature of craniopharyngiomas (hematoxylin-eosin, x100).
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Adamantinomatous craniopharyngiomas. Nodules of "...

Adamantinomatous craniopharyngiomas. Nodules of "wet" keratin frequently calcify; in aggregate, this calcification often can be detected on CT scans, and is a recognized radiologic feature of craniopharyngiomas (hematoxylin-eosin, x100).

Papillary craniopharyngioma. In contrast to the a...
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Media file 6: Papillary craniopharyngioma. In contrast to the adamantinomatous variant, papillary craniopharyngiomas do not show complex heterogeneous architecture (compare with Image 1) but rather are composed of simple squamous epithelium and fibrovascular islands of connective tissue (hematoxylin-eosin, x40).
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Papillary craniopharyngioma. In contrast to the a...

Papillary craniopharyngioma. In contrast to the adamantinomatous variant, papillary craniopharyngiomas do not show complex heterogeneous architecture (compare with Image 1) but rather are composed of simple squamous epithelium and fibrovascular islands of connective tissue (hematoxylin-eosin, x40).

Papillary craniopharyngiomas. Under high power, o...
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Media file 7: Papillary craniopharyngiomas. Under high power, only simple squamous epithelium is seen in a papillary craniopharyngioma. The distinctive peripheral nuclear palisading, internal stellate reticulum, and nodules of "wet" keratin, which typify the adamantinomatous variant, are not seen in the papillary variant (hematoxylin-eosin, x100).
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Papillary craniopharyngiomas. Under high power, o...

Papillary craniopharyngiomas. Under high power, only simple squamous epithelium is seen in a papillary craniopharyngioma. The distinctive peripheral nuclear palisading, internal stellate reticulum, and nodules of "wet" keratin, which typify the adamantinomatous variant, are not seen in the papillary variant (hematoxylin-eosin, x100).

Rosenthal fibers in neuropils surrounding a crani...
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Media file 8: Rosenthal fibers in neuropils surrounding a craniopharyngioma. The brain parenchyma that surrounds both variants of craniopharyngioma is typically gliotic and often shows profuse numbers of eosinophilic Rosenthal fibers. The latter structures are composed of densely compacted bundles of glial filaments and typically are seen in astrocytic cell processes of neuropils that have been subjected to chronic compression from slowly expanding mass lesions. Rosenthal fibers are a characteristic feature of juvenile pilocytic astrocytomas (JPAs), which also may arise in the suprasellar/third ventricular region. Hence, a biopsy that samples only the surrounding neuropil of a craniopharyngioma may yield an erroneous diagnosis of JPA if the pathologist is unaware of the close association of craniopharyngioma with Rosenthal fiber formation (hematoxylin-eosin, x100).
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Rosenthal fibers in neuropils surrounding a crani...

Rosenthal fibers in neuropils surrounding a craniopharyngioma. The brain parenchyma that surrounds both variants of craniopharyngioma is typically gliotic and often shows profuse numbers of eosinophilic Rosenthal fibers. The latter structures are composed of densely compacted bundles of glial filaments and typically are seen in astrocytic cell processes of neuropils that have been subjected to chronic compression from slowly expanding mass lesions. Rosenthal fibers are a characteristic feature of juvenile pilocytic astrocytomas (JPAs), which also may arise in the suprasellar/third ventricular region. Hence, a biopsy that samples only the surrounding neuropil of a craniopharyngioma may yield an erroneous diagnosis of JPA if the pathologist is unaware of the close association of craniopharyngioma with Rosenthal fiber formation (hematoxylin-eosin, x100).

More on Craniopharyngioma

Overview: Craniopharyngioma
Differential Diagnoses & Workup: Craniopharyngioma
Treatment & Medication: Craniopharyngioma
Follow-up: Craniopharyngioma
Multimedia: Craniopharyngioma
References
Further Reading
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Keywords

adamantinoma, craniopharyngeal duct tumor, Rathke pouch tumor, craniopharyngioma, cystic tumor, Rathke cleft, epithelial-squamous calcified cystic tumor

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Contributor Information and Disclosures

Author

George C Bobustuc, MD, Consulting Staff, Department of Neuro-Oncology, MD Anderson Cancer Center Orlando
George C Bobustuc, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, Society for Neuro-Oncology, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Morris D Groves, MD, Assistant Professor, Department of Neuro-Oncology, MD Anderson Cancer Center, University of Texas
Morris D Groves, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Gregory N Fuller, MD, PhD, Professor of Pathology, Chief, Section of Neuropathology, Department of Pathology, Division of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center
Gregory N Fuller, MD, PhD is a member of the following medical societies: American Association of Neuropathologists, College of American Pathologists, International Academy of Pathology, Society for Neuro-Oncology, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Franco DeMonte, MD, FRCSC, FACS, Professor of Neurosurgery, Mary Beth Pawelek Chair in Neurosurgery, The University of Texas, MD Anderson Cancer Center, Houston Texas
Franco DeMonte, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Amy A Pruitt, MD, Associate Professor of Neurology, University of Pennsylvania; Attending Neurologist, Hospital of the University of Pennsylvania
Amy A Pruitt, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jorge Kattah, MD, Head, Program Director, Professor, Department of Neurology, University of Illinois College of Medicine at Peoria
Jorge Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, and New York Academy of Sciences
Disclosure: Biogen Honoraria Consulting; Bayer Corporation Honoraria Consulting

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Tarakad S Ramachandran, MBBS, FRCP(C), FACP, Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital
Tarakad S Ramachandran, MBBS, FRCP(C), FACP is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners, American College of International Physicians, American College of Managed Care Medicine, American College of Physicians, American Heart Association, American Stroke Association, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, and Royal Society of Medicine
Disclosure: Abbott Labs  Honoraria Consulting; Teva Marion Honoraria Consulting; Boeringer-Ingelheim Honoraria Speaking and teaching

 
 
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