Presentation
Headaches.
Patient Data
The sella and suprasellar mass lesion demonstrates homogenous and prominent contrast enhancement, is centered 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. Tumor 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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