Hypothalamic-opticochiasmatic gliomas mimicking craniopharyngiomas

The differential diagnosis of suprasellar masses in the pediatric age group includes craniopharyngiomas and hypothalamic-opticochiasmatic gliomas (HOCGs). These tumors frequently display unique features on computed tomography and magnetic resonance imaging. We review two cases of pediatric suprasellar HOCGs with pre-operative imaging characteristics resembling those of craniopharyngioma. HOCGs mimicking craniopharyn-giomas represent a diagnostic and operative challenge to the pediatric neurosurgeon. Although an accurate leading pathologic diagnosis can frequently be made with preoperative neuroimaging, the neurosurgeon must be prepared for discovery of another tumor type and have plans to proceed accordingly.