Presentation
Gradual onset of vision loss and headache. Neglected case with low socioeconomic status from rural areas.
Patient Data
A well-demarcated large multilobulated sellar/supra sellar solid mass with left para sellar component. It is T1 and T2 isointense to brain grey matter and exhibits vivid homogeneous contrast enhancement. It measures about 3.3 x 3.5 cm in axial and 6.5 cm in CC diameters. It extends superiorly more to the left, elevating and compressing the optic chiasma and hypothalamus as well as the left lateral ventricle and splaying the interpedunclar cistern. It invades the left cavernous sinus encasing the left internal carotid artery, although it remains patent. Expansion of sella also noted, with no direct sphenoid sinus extension as well. The pituitary gland itself couldn’t be clearly visualized.
Imaging findings are in favor of sellar/suprasellar meningioma rather than and unlikely a pituitary macroadenoma?. For neurosurgical assessment and evaluation.
The rest of brain imaging is unremarkable.
Case Discussion
This is a presumptive radiological diagnosis with pending neurosurgical assessment and correlation.
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