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).