Presentation
Right eye visual loss and headache
Patient Data
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.
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 tumors / 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.