jean robert
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10 y.o. child with new onset of visual field abnormalities undergoes a head CT scan. the CT scan demonstrates a 3 -cm mass lesion with focal calcification involving the area above the sella turcica. Needle biopsy of this mass shows that the tumor is composed of tissue resembling thooth enamel. This patient s condition would most likely be associated with which of the following conditions?
a.- Diabetes insipidus
b.-Galactorrhea
c.-Gigantism
d.-Infertility
e.-Metastases
Edited by jean robert on 01/29/08 - 05:34 PM
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| pr20
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By exclusion,I will go with choice A.
The tumor is Craniopharyngioma.Apart from pressure symptoms(any CNS tumor can cause),craniopharyngioma can cause visual problems by pressing on optic chiasm or hormonal imbalances by pressing on pituitary gland(both due to suprasellar extension of the tumor).
Since it is a benign tumor,metastasis is not the correct choice.
Gigantism may not be correct because cranipharyngioma can cause decrease in GH due to pressing on pituitary gland but not oversecretion of GH,so it may more likely to cause stunted growth instead of gigantism.
Galactorrhea is most often a complication of Prolactinoma.
Remaining choices are A and D...Iam not sure but infertility due to CNS tumors may not be as common as hormonal imbalance problems....so I will go with A----->Diabetes Insipidus.
Central DI can be caused by damage to the hypothalamus or pituitary gland due to surgery,infections,trauma,tumors...etc.
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| new_n_lost
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a.- Diabetes insipidus ??
Yup RR pg 488
Edited by new_n_lost on 01/29/08 - 06:16 PM
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| angel23
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A-craniopharyngiomas
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| Tiff
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A. Diabetes Insipidus - ADH isn't being released from the posterior pituitary due to the craniopharyngioma
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| jean robert
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Correct Answer: A
The tumor is craniopharyngioma. Craniopharyngioma are benign tumors of epithelial cells that are derived from Rathke s pouch. They may arise in, or more commonly above, the sella turcica.
The histologic pattern recapitulates the enamel organ of the tooth, with nests or cords of stratified squamous or columnar epithelium embedded in a loose fibrous stroma. Calcification ( and even metaplastic bone formation ) is common in these benign tumors. These often impinge upon the optic chiasm, which can lead to a bitemporal hemianopsia. In addition, they can compress the pituitary gland, resulting in pituitary or adrenal dysfunction, diabetes insipidus, obesity, growth failure and hypothyroidism.
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