Presentation
Progressively increasing headache and vomiting for seven months. Previous medical history was hysterectomy and hypothyroidism.
Patient Data
CT scan shows a well defined lobular heavily calcified mass lesion at the sellar region measuring 25 x 22 x 15 mm.
MRI shows a well defined soft tissue mass lesion in the sellar region which enlarges the sella and extends to the suprasellar cistern, and right ethmoid and sphenoid sinuses. There is also a bilateral encasement of the carotid arteries especially at the left side (best shown on CT images). It is mainly homogenously hypo signal on both T1 and long TR images. After the administration of intravenous gadolinium the mass shows marked enhancement.
Case Discussion
The patient underwent a subfrontal craniotomy and the mass was completely excised.
Histopathology of the excised tumor revealed a psammomatous meningioma.
The differential diagnosis for a mass in the sellar region includes:
- macroadenoma
- craniopharyngioma
- Rathke's cleft cyst
- meningioma
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