Suprasellar meningioma

Case contributed by Dr Henry Knipe

Presentation

Headaches.

Patient Data

Age: 70 years
Gender: Male
MRI

The sella and suprasellar mass lesion demonstrates homogenous and prominent contrast enhancement, is centred on the tuberculum sella, extends across the pituitary fossa, bulges into the prepontine cistern, interpeduncular cistern, elevates the floor of the third ventricle, and optic chiasm and nerves, and displaces the anterior cerebral arteries. Anteriorly extends along the planum sphenoidale, with a dural tail of enhancement.

Differential enhancement separates the mass itself from the contiguous pituitary, which is seen inferiorly within the sella. 

The patient underwent transsphenoidal surgery.

Histopathology

MICROSCOPIC DESCRIPTION: Paraffin sections show a moderately hypercellular meningioma with a well-developed syncytial architecture. Tumour cells have uniform nuclear features. No mitotic figures or areas of necrosis are identified and there is no evidence of brain invasion. 

DIAGNOSIS: Meningioma.

Case Discussion

The common differential diagnosis for a sellar/suprasellar mass includes pituitary macroadenoma, meningioma, and craniopharyngioma. 

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Case information

rID: 55782
Published: 26th Sep 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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