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According to the case report, which was published online on Feb. 27 in the New England Journal of Medicine, the child underwent MRI of the brain after admission to the Johns Hopkins Children's Center, which revealed a mass (4.1 cm × 4.0 cm × 3.5 cm) close to the hypophysis. The doctors also identified structures near the mass similar to those of teeth in the mandible.
Upon surgical removal of the tumor, the surgeons found a number of teeth inside the mass, which was later identified as an adamantinomatous craniopharyngioma on pathological examination. Such slow-growing tumors arise from Rathke's pouch, an embryonic precursor to the anterior pituitary, and consist of stratified squamous epithelium and wet keratin, and may be cystic. The cysts are filled with viscous yellow fluid containing cholesterol crystals. The doctors explained that histologically adamantinomatous craniopharyngiomas closely resemble some odontogenic tumors.
The surgery was performed about a year ago. According to the case report, since then the patient has required shunting for bilateral subdural hygromas, and received thyroid and adrenal hormone-replacement therapy. However, he is making good developmental progress and undergoes MRI regularly, the doctors said.
