A Rare Occurrence of Craniopharyngioma Causing Visual Disturbance in Pregnancy

Craniopharyngioma is a rare and benign sellar and suprasellar region tumour. It rarely manifests during pregnancy. We report a 32-year-old primigravida at 19 weeks of gestation with a craniopharyngioma, presenting with visual disturbances during pregnancy. Her vision was 6/9 OD and counting fingers OS with a relative afferent pupillary defect in the left eye. Fundi were normal bilaterally. Visual field testing showed a nasal field defect OD and generalized depression OS. Brain magnetic resonance imaging revealed a suprasellar tumour with chiasmatic compression. Craniotomy and excision of the tumour were done at 20 weeks of gestation. Histopathological examination was consistent with craniopharyngioma. Postoperatively, mother and foetus were stable. Vision improved from counting fingers to 6/6 OS and remained at 6/9 OD. Subsequently, she delivered a healthy baby at term. Such rare and difficult cases warrant close multidisciplinary cooperation pre- and post-operatively to attain optimal outcomes for both mother and baby. By optimizing the patient's medical condition, risks of complications may be reduced. A poor pre-operative vision should also not deter surgical intervention as a proven good visual outcome is achievable.