Suprasellar meningioma

Case contributed by Dr Mostafa El-Feky

Presentation

Visual disturbances.

Patient Data

Age: 60 years
Gender: Female
CT

CT brain

Sellar and suprasellar hyperdense mass lesion is noted measuring 3.2 x 2.8 x 2.7 cm in dimensions with coarse peripheral calcifications. It is extending to the suprasellar cistern and subfrontal region.

MRI

MRI brain

The mass has abroad dural base along planum sphenoidale and extending through the pituitary fossa. It shows homogenous iso-intensity on T1WI, hypointensity on T2WI, hyperintensity on FLAIR with homogenous avid postcontrast enhancement and small anterior dural thickening. The pituitary fossa is not enlarged. It is compressing the pituitary gland downwards and compressing the optic chiasm as well as splayin of circus of willis arteries. Differential enhancement separates the mass itself from the contiguous pituitary. There is no evidence of extension into the pituitary fossa, cavernous sinuses or orbital apex.

Case Discussion

Morphology and signal characteristics of the mass lesion arising from planum sphenoidale are consistent with a sprasellar meningioma, which was proved after surgical resection. the identification of normal pituitary gland separate from the mass excludes pituitary origin. Its mass effect upon the optic chiasm causes visual disturbances wich the most common presenting symptom. The common differential diagnosis for a sellar/suprasellar mass includes pituitary macroadenoma, meningioma, and craniopharyngioma

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Case information

rID: 64465
Published: 28th Nov 2018
Last edited: 8th Dec 2018
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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