HS, a 46-year-old male presented with decreased vision in his left eye along with impotence and diminished energy levels of about 3 months duration. His endocrine evaluation revealed pan-hypopituitarism. He was diagnosed with a suprasellar mass, mixed solid-cystic [Figure and ] and underwent an image-guided stereotactic (using skull fiducials) brain biopsy and aspiration of the cyst, which contained about 4 cc of oily fluid. Histologic review revealed a papillary CP. One month later he underwent Gamma Knife radiosurgery on the residual tumor []. Postoperatively he did well with a gradual improvement in his vision and a decrease in tumor size as seen on imaging 5 years following initial treatment [Figure and ]. His pan-hypopituitarism remained stable and he is currently being managed with hormone replacement therapy. Six years following Gamma Knife stereotactic radiosurgery (GKRS) treatment, his tumor recurred and he underwent an extended transphenoidal surgery presently remaining free of radiographic tumor.
MO, a 24-year-old male presented at an outside hospital with headaches of a few months in duration with a loss of libido and decreased energy levels. His endocrine workup revealed hypopituitarism and imaging showed a 2.5 cm sellar-suprasellar solid cystic mass for which he underwent a cyst aspiration and biopsy. He subsequently had tumor progression and was treated with GKRS. Long-term follow-up at 9 years continues with the patient remaining stable and requiring no further interventions.