Suprasellar cistern lipoma - tuber cinereum

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Incidental finding.

Patient Data

Age: 30 years
Gender: Female

Small well defined nodular hypothalamic lesion within the tuber cinereum measuring 9 x 6 x 4 mm of high signal on both T1 and T2, attenuated on T1 fat sat with no solid enhancing component on post contrast sequences.

Case Discussion

MRI features most consistent with suprasellar cistern lipoma within the tuber cinereum (incidental finding in this case).

The differential diagnosis includes:

  • dermoid: mature teratoma
    •  less common
    • often more heterogeneous in signal (due to the presence of hair desquamated cells, etc)
  • teratoma: immature teratoma
    • similar to dermoid, but usually have a solid enhancing or cystic component
  • hamartoma 
    • usually no fat content
    • children with precocious puberty, visual problems
  • osteolipoma
    • ossification of a lipoma

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