It is the most common non-glial childhood brain tumor. Bimodal distribution with peaks in the first and between fifth to seventh decade. Great variance in size. Cyst fluid yellow, tan, green, dark black or even milky white. The cyst contents are comprised of cholesterol-laden fluid perhaps from repeated small hemorrhages within the tumor capsule.
Papillary structures are common with islands of squamous cells seen.
Deposition of keratin-like material. Intense glial reaction in surrounding brain, but tumors are not adherent to brain. May be adherent to arteries at the base of the brain. Despite their benign histological appearance, craniopharyngiomas frequently cause progressive neurological deterioration and death because of their propensity to involve critical structures in the suprasellar regions such as the hypothalamus, optic nerves and pituitary stalk. Detailed histopathological examinations have shown that the posterior extent of a craniopharyngioma blends imperceptibly with normal basal forebrain structures such as the hypothalamus.