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Altered signal intensity lesion in suprasellar region, in midline and left of it, between optic chiasma and mamillary bodies. The lesion appears isointense on T1 and slightly hyperintense on T2/FLAIR images. It is seen to extend up to the 3rd ventricle, causing mild mass effect at the inferior aspects. It is splaying optic chiasma on left side and left optic tract. Left mamillary body is not separately identifiable and is likely infiltrated and displaced medially. The lesion is abutting brainstem posteriorly with no evidence of infiltration.
The pituitary gland and infundibulum are normal.
The clinical presentation, location and appearance of the lesion on MRI are highly specific for a hypothalamic hamartoma.