A two-year-old male, with delayed neuropsychomotor development underwent computed tomography and magnetic resonance imaging (Figure). The diagnosis was persistent craniopharyngeal canal.
A: Magnetic resonance, constructive interference in steady state 3D sequence, sagittal plane; B: Magnetic resonance, T1, sagittal plane; C: Magnetic resonance, T2, axial plane; D: Computed tomography, bone window, axial plane. The persistence of the craniopharyngeal canal (arrows in C and D), and the pituitary remnant inside (arrows in A and B). Note that the remnant of the pituitary gland is lower than usual in the nasopharyngeal roof.
Persistent craniopharyngeal canal is a rare congenital anomaly of the skull base and is defined as a well-corticated osseous canal, extending from the roof of the nasopharynx to the base of the sella, over the sphenoid corpus, allowing the pituitary gland to present as a nasopharyngeal mass. Its origin may represent the remnant of the route of Rathke's pouch11. Akyel NG, Alimli AG, Demirkan TH, Sivri M. Persistent craniopharyngeal canal, bilateral microphthalmia with colobomatous cysts, ectopic adenohypophysis with Rathke cleft cyst, and ectopic neurohypophysis: case report and review of the literature. Childs Nerv Syst. 2018 Jul;34(7):1407-10. https://doi.org/10.1007/s00381-018-3747-4
https://doi.org/10.1007/s00381-018-3747-...
. Computed tomography and magnetic resonance imaging evaluate the content and limits of the canal well, preventing surgical iatrogenesis, such as hypopituitarism and cerebrospinal fluid leakage22. Mohindra S, Gupta K, Mohindra S. A novel minimally invasive endoscopic repair in a case of spontaneous CSF rhinorrhea with persistent craniopharyngeal canal. NeurolIndia. 2015;63(3):434-6. https://doi.org/10.4103/0028-3886.158243
https://doi.org/10.4103/0028-3886.158243...
.
References
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1Akyel NG, Alimli AG, Demirkan TH, Sivri M. Persistent craniopharyngeal canal, bilateral microphthalmia with colobomatous cysts, ectopic adenohypophysis with Rathke cleft cyst, and ectopic neurohypophysis: case report and review of the literature. Childs Nerv Syst. 2018 Jul;34(7):1407-10. https://doi.org/10.1007/s00381-018-3747-4
» https://doi.org/10.1007/s00381-018-3747-4 -
2Mohindra S, Gupta K, Mohindra S. A novel minimally invasive endoscopic repair in a case of spontaneous CSF rhinorrhea with persistent craniopharyngeal canal. NeurolIndia. 2015;63(3):434-6. https://doi.org/10.4103/0028-3886.158243
» https://doi.org/10.4103/0028-3886.158243
Publication Dates
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Publication in this collection
Dec 2018
History
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Received
16 Apr 2018 -
Reviewed
30 July 2018 -
Accepted
08 Aug 2018
