Primary ectopic frontotemporal craniopharyngioma

• We described the first case of a primary ectopic fronto-temporal craniopharyngioma.
• A primary ectopic craniopharyngioma is a tumor that arises for the first time without previous surgery in any compartment with no midline involvement from remnants of the Rathke’s pouch.
• Keyhole endoscopic approach gives a better screen image of neurovascular elements, better illumination and less brain retraction.

IntroductionPrimary ectopic craniopharyngiomas have only rarely been reported. Craniopharyngiomas involve usually the sellar and suprasellar region, but can be originated from cell remnants of the obliterated craniopharyngeal duct or metaplastic change of andenohypophyseal cells. We present the first case of a primary ectopic frontotemporal craniopharyngioma.Presentation of caseA 35-year old woman presented with a one-year history of headache and diplopia. MRI showed a large frontotemporal cystic lesion. Tumor resection was performed with a keyhole endoscopic frontal lateral approach. The pathological features showed an adamantinomatous craniopharyngioma with a cholesterol granuloma reaction.DiscussionThere have been reported different localizations for primary ectopic craniopharyngioma. Our case presented a lobulated frontotemporal cystic mass formed by a dense eosinophilic proteinaceous material dystrophic calcifications and cholesterol crystals, with epithelial remnants. No tumor regrowth was observed in the magnetic resonance image 27 months postoperatively.ConclusionPrimary ectopic craniopharyngioma is a rare entity with a pathogenesis that remains uncertain. This is an unusual anatomic location associated with unique clinical findings.