Craniopharyngioma CT

The CT findings depend on the subtype of craniopharyngioma. On CT, the adamantinomatous type is characterized by large cysts, vivid enhancement and peripheral calcifications. The papillary type tend to be more spherical in outline and usually lack the prominent cystic component and are mostly solid. Calcification is rare.

Although similar in terms of location, radiographic features depend on the subtype. There is a significant minority of tumors having both adamantinomatous and papillary components that many show overlapping features.^[1]

• Adamantinomatous type is the most common form (90%), and typically have a lobulated contour as a result of usually multiple cystic lesions.
• Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on CT scans.
• The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the third ventricle, and encasing vessels, and even being adherent to adjacent structures.
• The findings on CT are:^[2]

• Cysts
  • Typically large and a dominant feature
  • Near CSF density
• Solid component
  • Soft tissue density
  • Enhancement in 90%
• Calcification
  • Seen in 90%
  • Typically stippled and often peripheral in location.^[3]
  • 85% T1 hypointense

Papillary craniopharyngioma tend to be more spherical in outline and usually lack the prominent cystic component; most are either solid or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on CT are:^[4]

• Cysts
  • Small and not a major feature
  • Near CSF density
• Solid component
  • Soft tissue density
  • Vivid enhancement
• Calcification
  • Uncommon, rare

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