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A young pre-pubertal female patient presented to the medical department with bilateral marked loss of vision. She also complained of facial and bipedal edema in the near past though other features of hypothyroidism were lacking in her history. She had a strong history of mental disorders in the family. General physical examination was unremarkable. Abdominal examination revealed hepatomegaly. Central nervous system examination showed bilateral optic atrophy and an up-going left plantar response. Baseline investigations were normal. Thyroid functions suggested sub-clinical hypothyroidism. MRI scan of the brain and orbits revealed a locally invasive cystic lesion with solid components, encasing the major structures consistent with craniopharyngioma. Partial excision of the lesion was carried out, and biopsy report confirmed it to be an adamantinoma variety of craniopharyngioma.
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