A 24-year-old female patient presented with a cystic craniopharyngioma that appeared on a computed tomographic (CT) scan as a huge, homogeneous, high-density mass extending into the left temporal lobe and posterior fossa. She had undergone partial removal of a suprasellar tumor and cyst aspiration 17 years previously, at the age of 7. The tumor recurred with atypical clinical symptoms. Unusual clinical manifestations are discussed and an explanation for the CT appearance of the tumor, based on chemical analysis of the cyst content, is proposed.