Meningioma - psammomatous

Case contributed by Dr Saeed Soltany Hosn

Presentation

Progressively increasing headache and vomiting for seven months. Previous medical history was hysterectomy and hypothyroidism.

Patient Data

Age: 55 years
Gender: Female
CT

CT scan shows a well defined lobular heavily calcified mass lesion at the sellar region measuring 25 x 22 x 15 mm.

MRI

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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Case information

rID: 33441
Published: 13th Jan 2015
Last edited: 25th Sep 2018
Inclusion in quiz mode: Included

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