7-year-old boy with history of craniopharyngioma status post cyst fenestration and proton therapy. Now with crossed eyes and headaches. Bilateral transfrontal catheters terminate in the mixed cystic and solid craniopharyngioma, their position is unchanged. Since the prior exam the majority of the cystic components of the tumor have resolved and the tumor has overall decreased in size with the enhancing portion surrounding the optic chiasm measuring approximately 20 mm in AP dimension (series 1001, image 8) and 17 mm in craniocaudal dimension (series 1101, image 5), previously 25 x 23 mm. There is no new mass effect on the optic chiasm. Patchy T2 signal abnormality in the optic apparatus is grossly unchanged. The brain parenchyma otherwise appears unremarkable and there are no other areas of abnormal intracranial enhancement. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Interval decrease in cystic components of the craniopharyngioma and an overall decrease in total craniopharyngioma size.2.Stable ventricular size.