Postoperative outcome and visual recovery following surgical treatment of adamantinomatous craniopharyngioma in a child

Background. Sellar and suprasellar tumors can cause visual impairment due to compression of the optic pathways, with bitemporal hemianopia representing a characteristic visual field defect associated with chiasmal involvement. Case report. A 13-year-old boy presented with one month of progressive bilateral blurred vision, more pronounced in the left eye. Best-corrected visual acuity was 20/25 in the right eye and light perception in the left eye. Initial visual field examination demonstrated severe, asymmetric visual field loss. Fundoscopic examination revealed bilateral optic disc atrophy, and optical coherence tomography of the retinal nerve fiber layer showed marked thinning. Magnetic resonance imaging revealed an intrasellar mass with suprasellar extension. The patient underwent transsphenoidal tumor resection followed by hormonal replacement therapy, and histopathological analysis confirmed adamantinomatous craniopharyngioma. At the final follow-up of three months postoperatively, visual acuity improved to 20/20 in the right eye and 20/50 in the left eye. Visual field testing demonstrated residual bitemporal hemianopia. Conclusions. Optic atrophy and bitemporal hemianopia are classic manifestations of suprasellar tumors. Early diagnosis and multidisciplinary management are essential to optimize visual outcomes.