A case of suprasellar craniopharyngioma presented as severe depressive episode without psychotic symptoms

Abstract INTRODUCTION: Craniopharyngiomas are benign neoplasms that are usually suprasellar in origin. They are considered a type of pituitary tumour that can cause hyposecretion of anterior pituitary hormones or hypopituitarism. Clinically, they may cause visual and endocrine deficiencies similar to pituitary adenoma. Clinical presentation is variable on account of variable locations and size of tumour. It mainly includes: Headache, visual symptoms, decreased libido, amenorrhea, diabetes insipidus, behavioural changes due to frontal or temporal extension. CASE REPORT: A 40 years old married male, graduate, presented with 6 months history of gradual onset and progressive course of symptoms features by low mood, decreased energy, decreased social interaction, disturbed sleep and appetite and 2-3 months history of stiffness of neck, difficulty in near and distance vision, episodic headache, forgetfulness since last 1 years. He was admitted with a provisional diagnosis of Severe Depressive episode without Psychotic Symptoms. MRI Brain scan to rule out further organicity and was diagnosed as a suprasellar craniopharyngioma. Later, patient underwent bilateral craniotomy with tumour excision. CONCLUSION: Craniopharyngiomas remains undiagnosed without proper investigation and it will further increase risk regarding treatment and its outcome. This case demonstrate that behavioural disturbances can be the initial presentation of slow growing diencephalic tumours.