Suprasellar meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Headaches and decreased vision.

Patient Data

Age: 65 years
Gender: Female

CT brain

Modality: CT

Non-contrast CT demonstrates a slightly hyperdense mass centred on the pituitary fossa / suprasellar cistern. 

MRI pituitary

Modality: MRI

Unfortunately the patient struggled to keep still, degrading the images a little.  A mass measuring 25 x 25 x 25mm it is located in the suprasellar region. It is isointense to grey matter on both T1 and T2 weighted sequences and demonstrates intermediate restriction on the diffusion weighted images similar to cortex. Following administration of contrast it demonstrates homogeneous enhancement. The pituitary fossa is not enlarged, and what appears to be normal pituitary tissue is located base of the fossa below the mass. This tissue demonstrates dynamic contrast enhancement also consistent with normal pituitary tissue. The mass extends both anteriorly along the planum sphenoidale, and over the dorsum sellae and a little way down along the clivus with a small dural tail.

The cavernous sinuses and sphenoid sinus appear unremarkable.

The supraclinoid internal carotid arteries are displaced laterally, with the anterior cerebral artery is displaced anterosuperiorly, draped over the mass. There is approximately 12 mm between the planum sphenoidale and the anterior cerebral arteries in the midline.

The remainder of the imaged brain (please note this scan has been targeted to the pituitary region, and thus does not image the whole brain) is unremarkable in appearance.

Case Discussion

The patient eventually had the mass resected confirming a meningioma. 

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Case Information

rID: 15824
Case created: 14th Nov 2011
Last edited: 22nd Jan 2016
Inclusion in quiz mode: Included

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