Craniopharyngioma associated with Parathyroid Adenoma, Cerebral Arteriovenous Malformations, and Persistent Left Superior Vena Cava

Case Report

Abstract

A 36-year-old, right-handed male was hospitalized complaining of bilateral visual disturbance. A computed tomography (CT) scan revealed a suprasellar mass, which was diagnosed as craniopharyngioma. Preoperative examinations disclosed two cerebral arteriovenous malformations (AVMs) and hypercalcemia. Surgical resection of the mass followed by irradiation resulted in disappearance of the visual disturbance. Further examination showed that primary hyperparathyroidism was responsible for the hypercalcemia. In a second operation cerebral AVMs and a parathyroid adenoma, which had caused the primary hyperparathyroidism, were successfully resected. A persistent left superior vena cava (SVC), incidentally found by thoracic CT, was confirmed by angiography. The presence in one patient of two tumorous lesions, craniopharyngioma and parathyroid adenoma, and two vascular anomalies, cerebral AVMs and persistent left SVC, is extremely rare. It is possible that they have a common etiological source, although at present the authors can only speculate about the origin(s) of the multiple pathologies in this unusual case.