Meningioma of the tuberculum sella

Case contributed by Dr Prashant Gupta

Presentation

Right eye visual loss and headache

Patient Data

Age: 35
Gender: Female

Well defined suprasellar solid mass seen which shows homogenous enhancement and a broad dural attachment to the planum sphenoidale.

Note that the diaphragma sellae is not "pushed up" as it would have been with a macroadenoma, but rather is depressed, indicating this mass is of suprasellar origin.

On plain scans the mass is seen separate from pituitary gland.

Annotated image

This study illustrates a number of important signs of how to distinguish a suprasellar mass from one arising from the pituitary: 

  • dural tail (blue arrow): helpful is suggesting that this is a meningioma (note that other tumours / conditions can do this too, e.g. lymphocytic hypophysitis, metastases)
  • depression of the diaphragma sella (red arrow): in keeping the with mass pushing down into the sella, rather than rising out of the sella
  • pituitary gland (yellow arrow) can be seen as separate from the mass (m) best seen on T2 weighted imageas. 

Case Discussion

This case illustrates characteristic appearances of a meningioma of the tuberculum sella. 

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Case information

rID: 17360
Case created: 7th Apr 2012
Last edited: 24th Jan 2016
Inclusion in quiz mode: Included

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