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Case History

The patient is a 33-year-old female with large suprasellar mass. 

What is a supplemental IHC that can be done to help predict possible post-op complications?

  1.       GFAP
  2.       IDH-1
  3.       BRAF V600E
  4. TTF-1
   HE 1   HE 2

Answer: D. TTF-1

Dx: Adamantinomatous craniopharyngioma, WHO Grade 1

-Aggressive clinical course - invasive and recurrent
-Post-op complications can include chemical meningitis from keratin spillage into the CSF and diabetes insipidus from resection of post pituitary. Fragments of post pituitary can be identified with a TTF-1 stain where the glial cells will demonstrate nuclear positivity.
-Molecular: CTNNB part of the WNT pathway nuclear (+) for beta catenin
-3 micro features – wet keratin, basal palisading and loose reticulum

Case contributed by: Astin Powers, M.D., Neuropathology Fellow