Citation: Miyakoshi A, Kohno M, Sora S, Sato H and Yokoyama M. Primary Squamous Papillary-Type Craniopharyngioma in the Cerebellopontine Angle: Report of Two Cases. Austin Neurosurg Open Access. 2017; 4(1): 1054. Austin Neurosurg Open Access - Volume 4 Issue 1 - 2017 Submit your Manuscript | www.austinpublishinggroup.com Miyakoshi et al. © All rights are reserved Austin Neurosurgery: Open Access Open Access Abstract We report two rare cases of primary squamous papillary-type craniopharyngioma that developed in the Cerebellopontine (CP) angle. A 54-year-old woman and 26-year-old man were operated on for partially calciied CP angle tumors. One tumor showed is intensity and the other showed hyperintensity on T1-weighted magnetic resonance images. The small nodules of the tumors were the only part requiring contrast enhancement. The tumors were diagnosed neuropathologically as squamous papillary-type craniopharyngiomas. Although the most frequent tumors occurring in the CP angle are schwannomas, meningiomas and epidermoid cysts, the possibility of craniopharyngioma should be considered in cases in which the cyst exhibits hyperintensity in the T1-weighted magnetic resonance imaging scan, inhomogeneous contrast enhancement, and concomitant calciication in the computed tomography scan. Keywords: Cerebellopontine angle; Ectopic craniopharyngioma; Squamous papillary type; Cerebellopontine angle tumor Abbreviations CP: Cerebellopontine; CT: Computed Tomography; MRI: Magnetic Resonance Imaging; MR: Magnetic Resonance; FLAIR: Fluid-Attenuated Inversion-Recovery Introduction Craniopharyngioma is a benign epithelial tumor that originates from the Rathke pouch and usually develops around the parasellarregion. By pathology the tumor is divided into two main types, the adamantinomatous type and squamous papillary type. In contrast to the usual parasellar location, primary craniopharyngioma developing in the Cerebellopontine (CP) angle is extremely rare, with only eleven cases reported to date [1-9]. Ten of these cases were of the adamantinomatous type and one was of the squamous papillary type [1-7,9]. Here, we report the neuroradiological indings from two additional cases of squamous papillary-type craniopharyngioma that developed in the CP angle and were isolated from the parasellar region. Case Presentation Case 1 A 54-year-old woman presented with hearing impairment and facial numbness on the let side. Additional symptoms included dizziness and a tendency to lean to the let when walking. Neurological examination revealed deafness in the let ear, let facial hyperesthesia, horizontal spontaneous nystagmus to the right and a positive Romberg sign. A Computed Tomography (CT) scan identiied a hyperdense mass with nodular calciied spots on the let CP angle (Figure 1a). Magnetic Resonance Imaging (MRI) revealed an extra-axial tumor, which showed high intensity on T1-weighted Magnetic Resonance Case Report Primary Squamous Papillary-Type Craniopharyngioma in the Cerebellopontine Angle: Report of Two Cases Miyakoshi A 1 *, Kohno M 1 , Sora S 1 , Sato H 1 and Yokoyama M 2 1 Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Japan 2 Department of Diagnostic Pathology, Tokyo Metropolitan Police Hospital, Japan *Corresponding author: Miyakoshi A, Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Japan Received: January 20, 2017; Accepted: February 26, 2017; Published: February 28, 2017 (MR) images (Figure 1c) and low intensity in T2-weighted MR images (Figure 1b). he small nodule of the tumor was the only part requiring contrast enhancement (Figure 1 d). he patient was therefore operated on via a lateral sub occipital approach. A cystic tumor was identiied, with a rust-colored component being visible through the wall of the capsule. Following the opening of the cyst a motor oil-like luid and semisolid component were drained. he 3 rd nerve and pituitary stalk were identiied beyond the arachnoid membrane with neither showing any sign of contact with the tumor (Figure 1e). Postoperative MRI revealed near-total resection of the tumor (Figure 1f). Neuropathology showed that the wall of the cyst was composed of squamous epithelium with a papillary structure (Figure 1g). In contrast, the tumor contained keratinous material, cholesterin crystal and a ibrous inlammatory granuloma (Figure 1h), and was diagnosed as a squamous papillary-type craniopharyngioma. Postoperatively, the patient’s hearing acuity, facial numbness and gait disturbance improved. No sign of recurrence has been observed on follow-up examination for six years. Case 2 A 26-year-old man presented with facial numbness on the right side, dizziness and a tendency to lean to the let when walking. Neurological examination revealed decreased sensation on the right side of the face. A CT scan of the head showed a hypodense mass with a nodular calciication in the right CP angle (Figure 2a). MRI further identiied a cystic extra-axial tumor that partially contained a solid component and was enhanced with gadolinium-containing contrast medium (Figure 2b-2d). he tumor was separate from the sella turcica and pituitary stalk (Figure 2b). he patient was operated on via a lateral sub occipital and