Intracranial teratoma: suprasellar

Case contributed by A.Prof Frank Gaillard

Presentation

Recent sudden onset of headache. CT found an abnormality; further assessment.

Patient Data

Age: 20 years
Gender: Male

MRI brain

Modality: MRI

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.

Histology

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.

Case Discussion

This case demonstrates appearances of largely fat containing mature suprasellar teratoma. 

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Case Information

rID: 17613
Case created: 30th Apr 2012
Last edited: 6th Nov 2015
Inclusion in quiz mode: Included

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