Immature teratoma arising from the brain is very rare. The intra and supra sellar localization is very exceptional. Its clinical symptoms and radiological aspects on TDM are similar to those of craniopharyngiomas but on MRI the fat signal characterize teratomas, but only the histological exam gives the confirmation of this last lesion and makes differential diagnosis with mature tumor whose prognosis is better than the immature one. Our observation illustrates all these problems.
Observation: LM, 6 years, female, is referred to our unit for craniopharyngioma. She complaints of headaches, vomiting and a decrease in visual acuity. On clinical exam we noted a blindness, diabetes insipidus and a statural deficit with hypothyroidism wich are confirmed by hormonal results. On TDM there is huge (60×32 mm) solid intra and supra sellar tumor with cysts and calcifications wich arrives to the third ventricule but on MRI there is a fat signal evocating a teratoma. histological exam of this very hemorrhage tumor argue for an immature teratoma.
Conclusion: This observation prouves that clinical and TDM aspects of craniopharyngiomas are similar with those of teratomas. Only the fat signal on the MRI argue for the teratoma. Histological exam is the only one wich makes the proof and the differential diagnosis between craniopharyngioma and mature or immature teratoma. The last one has the worst prognosis.