Ectopic Recurrence of a Craniopharyngioma

Craniopharyngiomas are rare, solid or mixed solid, cystic tumors that generally occur in the sellar and suprasellar regions of the central nervous system along the pituitary stalk near the optic chiasm. Although benign, patients clinically present with symptoms from mass effect or the resultant increase in intracranial pressures. The recurrence rate of craniopharyngiomas is high. When present, recurrence is typically at the site of the primary tumor bed. Here, we present a case of a 27-year-old male who was found to have a suprasellar mass on enhanced CT imaging. The mass was resected and a ventriculoperitoneal shunt was placed. The lesion was identified as a craniopharyngioma, and the patient completed treatment and was discharged appropriately. Ten years later, the patient presented with headaches and on enhanced CT imaging was found to have a radiopaque mass originating from the right lateral ventricle and extending into the splenius of the corpus callosum. This new lesion was identified as a craniopharyngioma. Ectopic recurrence of a craniopharyngioma is a rare phenomenon and is thought to be the result of direct seeding along the site of surgical resection or via cerebrospinal fluid circulation.