Intracranial teratoma: suprasellar
Recent sudden onset of headache. CT found an abnormality; further assessment.
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There is a left suprasellar mass that markedly indents the inferior frontal pole and and tips over the left parasellar region, but not along the greater wing. No extension to the optic canal or superior orbital fissure. The slightly heterogeneous contents show no enhancement and are almost completely fatty.
There is mass effect on the optic chiasm, the left optic nerve is stretched over this lesion. The left terminal internal carotid artery is displaced inferiorly by the tumour. There is minimal intraseller extension.
Scattered throughout the sulci of the brain numerous small hyperintense foci, consistent with fatty material. This is unchanged when compared to the prior study. No significant leptomeningeal enhancement is seen.
There is no hydrocephalus or intraventricular lipid-fluid level. No intra-axial mass is seen.
The sections show a lesion comprising skin, sebaceous glands, fat, calcification and cartilage. Amorphous and keratinous debris with hair shafts are identified. Adjacent cerebral cortex is present with attached cyst lining, associated with reactive gliosis. No immature elements are noted. There is no evidence of malignancy.
FINAL DIAGNOSIS: Suprasellar lesion: Mature teratoma.
This case demonstrates appearances of largely fat containing mature suprasellar teratoma.