NBME 20 Diverticulum of the roof of the embryonic oral cavity (NBME Answers)

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Retired NBME 20 Answers

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A 9-year-old girl is brought to the physician ...
Diverticulum of the roof of the embryonic oral cavity 🔍 / 📺 / 🌳 / 📖
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submitted by ∗hayayah(1212)

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Patient has a craniopharyngioma. Most common childhood supratentorial tumor. Derived from remnants of Rathke pouch (oral ectoderm). Calcification is common. Cholesterol crystals found in “motor oil”-like fluid within tumor.

A cystic suprasellar mass with calcifications and enhancement of the wall or solid portions in a child or adolescent is almost always a craniopharyngioma.

May be confused with pituitary adenoma (both cause bitemporal hemianopia).

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dickass Cholesterol crystals in motor oil +

passfail I also just thoughtL: failure to secrete GH = tumor affecting anterior pituitary hormone --> anterior pituitary is derived from Rathke's pouch +

ally123 "Due to the proximity of the tumor to the hormone-producing cells of the hypothalamus and the pituitary gland, there is significant endocrine dysfunction in most children and adolescents presenting with craniopharyngioma...Among the hormone deficiencies, growth hormone deficiency is the most common and is seen in approximately 75% of children with craniopharyngioma." Source: http://campus.neurochirurgie.fr/Programme_Enseignement/_art1030/endocrinManifest.pdf +

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submitted by ∗palib(1)

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Most adult primary brain tumors are above the tentorium (Supratentorial) and most childhood tumors are below the tentorium (infratentorial).... Craniopharyngioma is an exceptional to this as it is a childhood tumor that is supratentorial... it presents with bilateral hemianopia

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