ABSTRACT
We present a case of a purely infrasellar craniopharyngioma that initially presented
as a sphenoid sinus mass. Craniopharyngiomas are usually located within the sella.
Purely infrasellar craniopharyngiomas have only rarely been reported in the literature.
A 25-year-old woman presented with 6-month history of progressive headaches. Initial
neuroimaging revealed the presence of a sphenoid sinus mass. Initially, she underwent
an endoscopic biopsy of the mass by our ENT service. Pathology was consistent with
craniopharyngioma and she was referred to neurosurgery for further surgical management.
She then underwent an endoscopic transsphenoidal approach for complete resection of
the purely extracranial, infrasellar craniopharyngioma. The Rathke pouch arises from
the roof of the primitive mouth and grows toward the brain at the fourth week of gestation.
Normally, it loses its attachment with the stomadeum completely by the eighth week
of gestation. The craniopharyngeal canal (CPC) extends from the floor of the sella
to the vomer and may rarely give rise to ectopic craniopharyngiomas. This case shows
that such ectopic tumors may arise anywhere along the CPC. Endoscopic endonasal approach
provides an excellent route for the resection of these tumors.
KEYWORDS
Craniopharyngioma - ectopic - Rathke pouch - infrasellar
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Bharat GuthikondaM.D.
Department of Neurosurgery, LSUHSC-Shreveport
1501 Kings Highway, Shreveport, LA 71130
eMail: bguthi@lsuhsc.edu
