Dermoid cyst - suprasellar
Incidental finding on CT performed years ago for head trauma. Continued follow-up.
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MRI of the brain demonstrates an extra-axial mass with intrinsic high T1 which suppresses on fat suppressed sequences. It has heterogeneous signal on both T1 an T2 weighted images. It is separate from the pituitary and is intimately associated with the left A1 segment of the anterior cerebral artery.
The mass straddles the left optic nerve which is pushed inferiorly.
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This case illustrates typical appearances of a dermoid cyst, albeit at this stage not histologically confirmed. The only reasonable differential is that of a mature teratoma, although the absence of solid enhancing components or cystic non-lipid components does make that diagnosis much less likely.