9 year old male presents with poor p.o. intake

9 year old male presents with poor p.o. intake, weight loss, fatigue, and weakness in all extremities. Axial and sagittal noncontrast CT images show a large solid and cystic sellar/suprasellar mass. There are punctate calcifications in the mass (yellow arrow) and areas of hemorrhage adjacent to the mass (red arrows). A craniopharyngioma is a tumor derived from Rathke pouch epithelium. Often presenting with headache, vomiting, papiledema. Endocrine dysfunction may be present in 1/3 of cases. Most common non-glial pediatric intracranial tumor. Represents >50% of all pediatric suprasellar region tumors. Two types: adamantinomatous type peak age is 8-12 years, papillary type found in patients >50 years of age. Slow-growing benign tumor. 88% overall survival at 20 years, but often with some morbidity. If there is hypothalamic involvement, there is decreased overall survival and decreased quality of life.