Recurrent craniopharyngioma in the posterior fossa

Craniopharyngioma situated in the posterior fossa is rare. It has been unclear whether such lesions arise primarily in this site or represent direct spread from a suprasellar focus. We report a patient with recurrent craniopharyngioma which had extended into the posterior fossa as far as the cerebellopontine angle through the tentorial hiatus with evidence that it had done so directly. A further separate lesion of similar signal characteristics on MRI scan, lying in the prepontine area, probably represented a seeding from the suprasellar area.