CLINICAL, ENDOCRINOLOGICAL, AND LABORATORY ASPECTS OF CRANIOPHARYNGIOMA: A DISCUSSION BASED ON A CASE REPORT

Abstract

Craniopharyngioma is a rare benign epithelial tumor arising in the sellar and suprasellar region, associated with substantial morbidity due to compression of adjacent neurovascular and endocrine structures. We report the case of a 65-year-old woman with no significant past medical history who presented with progressive confusion, postural instability, and recurrent refractory hyponatremia. The diagnostic workup was initially prompted by the onset of peripheral facial palsy. Brain magnetic resonance imaging revealed a 3.9 × 2.8 × 2.5 cm mixed sellar and suprasellar mass with cystic components, calcifications, and septated solid areas, causing compression of the optic chiasm and optic nerves without cavernous sinus invasion. Craniopharyngioma was considered the leading diagnostic hypothesis. Neurological examination demonstrated a Glasgow Coma Scale score of 14 and persistent peripheral facial palsy, with no additional focal neurological deficits. Following neurosurgical evaluation, the patient was referred to a specialized center for definitive management. This case underscores the importance of considering an underlying intracranial lesion in patients presenting with nonspecific neurological symptoms and persistent electrolyte disturbances. Early neuroimaging is essential for timely diagnosis and appropriate multidisciplinary management, potentially reducing neurological, visual, and endocrine complications and improving functional outcomes.