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Late development of craniopharyngioma following surgery for Rathke's cleft cyst

 Park YS  ;  Ahn JY  ;  Kim DS  ;  Kim TS  ;  Kim SH 
 CLINICAL NEUROPATHOLOGY, Vol.28(3) : 177-181, 2009 
Journal Title
Issue Date
Adult ; Central Nervous System Cysts/metabolism ; Central Nervous System Cysts/pathology* ; Central Nervous System Cysts/surgery ; Craniopharyngioma/metabolism ; Craniopharyngioma/pathology* ; Craniopharyngioma/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasms, Second Primary/metabolism ; Neoplasms, Second Primary/pathology* ; Neoplasms, Second Primary/surgery ; Neurosurgical Procedures ; Pituitary Neoplasms/metabolism ; Pituitary Neoplasms/pathology* ; Pituitary Neoplasms/surgery ; beta Catenin/metabolism
OBJECTIVE: Rathke's cleft cyst (RCC) may transform to papillary type craniopharyngioma (CP) after squamous metaplasia: this is referred to as ciliated CP. We encountered a case involving a patient who had late development of adamantinomatous CP following surgery for RCC, the details of which may shed light on the histogenesis of CP in general. PATIENT: A 41-year-old man presented to our institution with visual disturbance, and magnetic resonance imaging (MRI) showed a cystic mass in the suprasellar region. The patient underwent a biopsy via a transsphenoidal approach and was diagnosed as having a RCC. 34 months after the initial surgery, the patient revisited our hospital for a rapidly aggravating visual disturbance and underwent neuroendoscopic biopsy and tumor removal via a bifrontal craniotomy. Histologically, the tumor was shown to be an adamantinomatous CP. No nuclear beta-catenin accumulation was detectable in the previous RCC specimen, but nuclear beta-catenin accumulation was found in the recent CP specimen, restricted to whorl-like structures or surrounding ghost cells. CONCLUSIONS: Our case of adamantinomatous CP that developed long after removal of the RCC, diagnosed by beta-catenin staining, supports the hypothesis that CPs may develop from RCCs directly due to beta-catenin mutations. However, it still does not prove that a histogenetic connection can be shown between the two lesions which are clonally unrelated. Our case is reported as two consecutive lesions; this in itself is a rare situation
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Tai Seung(김태승)
Park, Young Seok(박영석)
Ahn, Jung Yong(안정용)
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