Hypothalamic glioma masquerading as craniopharyngioma
A 25-year-old female patient presented with a history of headache, vomiting, and blurring of vision of 2-month duration. On examination the patient was conscious and cooperative. Visual acuity was 6/18 bilaterally. Fundus was normal. Reduction of the left temporal visual field was seen. Pupils were bilaterally symmetrical and reactive to light. CT and contrast-enhanced MRI of the brain [Figures –] was performed which revealed a solid cystic mass lesion involving the hypothalamus and the thalamus displacing and compressing the third ventricle. Inferiorly the lesion was extending into the interpeduncular cistern. The pituitary stalk and optic chiasm were not visualized separately from the lesion. The pituitary gland was normal in location and signal intensity. The solid component of the lesion showed enhancement on contrast administration. A provisional diagnosis of a suprasellar craniopharyngioma was given. The patient was subsequently operated upon and a right frontoparietal craniotomy with subtotal excision was performed. On histopathology the lesion was diagnosed as a hypothalamic glioma []. Post-surgery the patient developed central diabetes insipidus and is currently E4V4M4 status with left hemiplegia.