MR reveals a well-defined oval-shaped suprasellar-hypothalamic lesion at the midline which is isointense to cortical grey matter on non-contrast T1WI and slightly hyperintense on T2WI. No diffusion restriction was noted and lesion shows diffuse homogenous enhancement after contrast administration. There is a mass effect upon the optic chiasm and bilateral, symmetrical perilesional vasogenic edema.
Findings are most suggestive of suprasellar germinoma. Differential diagnoses included hypothalamic glioma and lymphoma.