Craniopharyngiomas: Topography and Prognosis

Craniopharyngiomas present two histologic subtypes: the adamantinous type typically seen in children and adolescents and the papillary type seen almost exclusively in adults. Adamantinous craniopharyngiomas present with three components: solid, cystic, and calcified. The solid component enhances after contrast. The signal of the cystic part is usually hyperintense on T1 and FLAIR and hypo or hyperintense on T2WI and without fluid-fluid level. Papillary craniopharyngiomas are generally well-circumscribed, predominantly solid tumors. The third ventricle is a common location of this subtype. The role of MRI is to define precisely the relationships between the craniopharyngioma and the hypothalamus, mainly the third ventricle floor and to detect the pure intraventricular form. Presence of a duct-like recess at the infundibular portion of a third ventricle tumor represents a distinctive hallmark of papillary craniopharyngiomas located within the third ventricle.