Sellar arachnoid cyst

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Headache, blurred vision.

Patient Data

Age: 60 years
Gender: Female
mri

There is a well defined large, lobulated lesion in sellar region. It appears hypointense in T1W images, exhibits CSF signal (hyperintense T2W and hypointense on FLAIR sequences). It shows no restricted diffusion on DWI/ADC, and no enhancement in T1 post contrast. It extends superiorly to the suprasellar cistern, displacing the optic chiasm superiorly, splaying adjacent arteries and to sphenoid sinuses inferiorly, with clivus remodeling. 

Case Discussion

Large lobulated cystic lesion in sella, follow CSF signal, with no restricted diffusion, no enhancement, displacing adjacent arteries, with bone remodeling, suggestive of arachnoid cyst.

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