Ectopic Craniopharyngioma of the Clivus: A Case Report

Craniopharyngioma is a rare benign epithelial tumor that usually arises in the sellar or suprasellar region. Ectopic craniopharyngioma of the clivus is exceptional and may present with nonspecific symptoms that mimic other skull base lesions.

We report a 56-year-old woman with a 4-year history of intermittent headache and occasional blurred vision. Ophthalmological consultation showed reduced visual acuity, but visual evoked potential testing and fundus photography were unremarkable. Perioperative endocrine testing showed a mildly elevated preoperative thyroid-stimulating hormone level and a postoperative decrease in triiodothyronine, adrenocorticotropic hormone, and cortisol, without documented diabetes insipidus or new neurological deficit. Magnetic resonance imaging and computed tomography demonstrated a cystic lesion in the sellar-clival region with clival thinning and compression. The patient underwent endoscopic endonasal transsphenoidal resection, and histopathology confirmed adamantinomatous craniopharyngioma. Postoperative imaging showed satisfactory resection, and the headache improved.

This case highlights that ectopic craniopharyngioma should be considered in patients with chronic headache and a cystic clival lesion, even when classic sellar symptoms are absent.