Rosenthal fibers as a diagnostic marker craniopharyngioma, an intraoperative study

Abstract

Craniopharyngioma is a sellar tumor with cystic and solid structures. The cystic areas contain aproteinaceous material described as “oil machinery”, little is known about the characteristics of this fluid. We studied a woman 60 years old with a long history of 10 years with visual disturbance until amaurosis. The MRI showed a sellar lesion. Intraoperative findings showed a necrotic yelloswish material with purulent appearance that was diagnosed as abscess. The intraoperative study with crush smears showed a dirty background with necrosis and lipo-proteinaceous material. Few inflammatory cells and abundant Rosenthal fibers formation were also observed. Epithelial cells were lacking. The presence of Rosenthal fibers and lipo-proteinaceous material has been observed in the boundary of this tumor, but those findings have been described as the same and may be helpful for the craniopharyngioma diagnosis. The presence of these indicates rupture of the cystic structure and conditions the output of the material that is damaging normal brain structures.