Presentation
Convulsions and gradual generalized body weakness.
Patient Data
A hyperechoic left para-midline well-defined sellar-suprasellar mass is demonstrated on cranial ultrasound. Lateral ventricles are grossly dilated bilaterally (left >right). No perfusion is demonstrated on Doppler interrogation.
MRI brain was recommended for further evaluation.
A large sellar-suprasellar well-marginated lobulated necrotic solid mass that is heterogeneous T2/FLAIR hyperintense and hypointense on T1WI. The solid component demonstrates enhancement on T1 C+ sequences.
The mass superiorly projects into the third and lateral ventricles (left>right) to cause severe obstructive hydrocephalus. Subependymal edema and peripheral effacement of cerebral sulcations is demonstrated.
Case Discussion
This is a case of a large sellar-suprasellar mass projecting into the third and lateral ventricles with resultant severe obstructive hydrocephalus.
The mass has sonographic and MRI features that are suggestive of an adamantinomatous craniopharyngioma.
Tissue diagnosis and surgical review was recommended for further assessment. However, the patient succumbed before any further investigations could be carried out.
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