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NBME 21 Answers

nbme21/Block 2/Question#37

A 17-year-old boy is evaluated for constitutional ...


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submitted by sbryant6(28),

Craniopharyngioma with Calcifications and Cholesterol Crystals (motor-oil fluid). Remnant of Rathke's pouch. Not to be confused with pituitary adenoma.

dubywow  Also, craniopharyngioma is most common supratentorial childhood tumor. That was the big clue for me. +  

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submitted by aesalmon(38),

Can anyone explain why this is not a pituitary adenoma? Is it just a lack of other symptoms?

benzjonez  I think that they just wanted you to notice the **calcifications**. Per FA, "calcifications are common in craniopharyngiomas," whereas I don't think you'd expect to see calcifications in a prolactinoma. +6  
epr94  also the option is prolactinoma not broad pituitary calcifications and he doesnt show any specific signs of high prolactin +