Sinonasal polyposis with suprasellar mass (presumably meningioma)

Case contributed by Dr Amro Omar

Presentation

Headache, visual disturbance and progressive nasal stuffiness and obstruction.

Patient Data

Age: 57
Gender: Male

CT shows rounded, peripherally calcified suprasellar mass and the classic appearance of sinonasal polyposis with multiple lobular soft tissue involving the nasal cavity and paranasal sinuses, please note that there is slight bony expansion and no bone destruction, which differentiates the sinonasal polyposis from aggressive tumors.

MRI shows an extra axial suprasellar and intensely enhancing mass, with dural tail arising from the dura of the tuberculum sellae. There are compression on the 3rd ventricle and the optic chasm. No evidence of cavernous sinus invasion. 

Again noted, the sinonasal polyposis with some secretions of proteinaceous signal.

Case Discussion

Differential diagnosis of calcified suprasellar mass includes many entities . However , regarding patient's age and radiological appearance , meningioma is most likely diagnosis. Unfortunately , patient was lost in follow up

Important note : On the CT study, one differential diagnosis that must be excluded is a calcified suprasellar aneurysm , or consequences will be catastrophic !!!

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Case information

rID: 32629
Case created: 6th Dec 2014
Last edited: 22nd Feb 2016
Inclusion in quiz mode: Included

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