• Atef Ben Nsir, Quoc-Anh Thai, Larbi Chaieb, and Hafedh Jemel.
• Department of Neurosurgery, Fattouma Bourguiba University Hospital - University of Medicine of Monastir, Monastir, Tunisia. Electronic address: atefbn@hotmail.fr.
• World Neurosurg. 2015 Sep 1;84(3):866.e11-4.

BackgroundXanthogranuloma, also known as cholesterol granuloma, is an extremely rare intracranial neoplasm most commonly located in the middle ear, petrous apex, or choroid plexus. Exclusively suprasellar xanthogranulomas are exceptional and this report presents a very rare case in the pediatric population, particularly unique due to the presence of calcification.Case DescriptionA 17-year-old girl presented with primary amenorrhea with computed tomography and magnetic resonance imaging showing a large calcified enhancing suprasellar mass, which was presumptively diagnosed as a craniopharyngioma on the basis of its clinical and radiologic appearance. Gross total resection of a well-encapsulated, exclusively suprasellar tumor was achieved, without postoperative neurologic deficits. Histologic examination found fibrous tissue with abundant cholesterol clefts, multinucleated giant cells, and hemosiderin deposits but no epithelial cells. The final histologic diagnosis was a xanthogranuloma.ConclusionsXanthogranuloma, although extremely rare in the pediatric population, may present as a calcified suprasellar mass and manifest with primary amenorrhea. The prognosis after gross total resection is likely favorable; however, long-term follow-up is indicated for these rare neoplasms.Copyright © 2015 Elsevier Inc. All rights reserved.

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