A computed tomography (CT) scan is also a good diagnostic tool, as it detects calcification in the tumor.Two distinct types are recognized:
Adamantinomatous craniopharyngiomas, which resemble ameloblastomas (the most common type of odontogenic tumor), are characterized by activating CTNNB1 mutations. Papillary craniopharyngiomas are characterized by BRAFv600E mutations.In the adamantinomatous type, calcifications are visible on neuroimaging and are helpful in diagnosis. The papillary type rarely calcifies. A vast majority of craniopharyngiomas in children are adamantiomatous, whereas both subtypes are common in adults. Mixed-type tumors also occur.On macroscopic examination, craniopharyngiomas are cystic or partially cystic with solid areas. On light microscopy, the cysts are seen to be lined by stratified squamous epithelium. Keratin pearls may also be seen. The cysts are usually filled with a yellow, viscous fluid rich in cholesterol crystals. Of a long list of possible symptoms, the most common presentations include headaches, growth failure, and bitemporal hemianopsia. Malignant craniopharyngioma
Craniopharyngiomas are usually successfully managed with a combination of adjuvant chemotherapy and neurosurgery. Recent research describes the rare occurrence of malignant transformations of these normally benign tumors.
In premenopausal women, elevated prolactin can lead to reduction or loss of menstrual periods and/or breast milk production (galactorrhea). With stalk effect, prolactin levels are usually only slightly elevated, as opposed to prolactinomas in which the prolactin level is usually very high. Diabetes insipidus occurs due to the absence of a posterior pituitary hormone called antidiuretic hormone. Symptoms include:
Excessive thirst
Excessive urination
Adrenal insufficiency occurs because of a reduction in ACTH production, a reduction in cortisol. In severe cases, it can be fatal. Symptoms include:
Fatigue
Low blood pressure
Electrolyte abnormalities

Mechanisms
Craniopharyngioma is a rare, usually suprasellar neoplasm, which may be cystic, that develops from nests of epithelium derived from Rathkes pouch. Rathkes pouch is an embryonic precursor of the anterior pituitary.Craniopharyngiomas are typically very slow-growing tumors. They arise from the cells along the pituitary stalk, specifically from nests of odontogenic (tooth-forming) epithelium within the suprasellar/diencephalic region, so contain deposits of calcium that are evident on an X-ray. Diagnosis
Imaging scans for craniopharyngioma
A physician can conduct a few scans and tests to diagnose a person with craniopharyngioma. High-resolution magnetic resonance imaging (MRI) is valuable because it allows the neuroradiologist to view the tumor from different angles.In some cases, a powerful 3T (Tesla) MRI scanner can help define the location of critical brain structures affected by the tumor. The histologic pattern consists of nesting of squamous epithelium bordered by radially arranged cells. It is frequently accompanied by calcium deposition and may have a microscopic papillary architecture.