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General Reference

Nejm 1994;331:1506; 1991;324:1555

Pathophys and Cause

Cause:Neoplasia

Pathophys: Suprasellar tumor arising from pharyngeal epithelium

Epidemiology

Mainly in children

Signs and Symptoms

Sx:

Adults: headache; bitemporal hemianopsia; hypothalamic dysfunction including personality changes, obesity, diabetes insipidus, sleep changes

Children: growth failure

Course

Slow growing, with rx live at least 15 yr

Complications

Panhypopituitarism postop (80-90%)

Lab and Xray

Xray:MRI or CT shows calcification in 95%

Treatment

Rx:Surgery difficult in floor of 3rd ventricle, 70% able to be completely resected, 90% cures w postop radiation

Radiation: quite sensitive, gives 5-10 yr of asx life; often used postsurgery