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Suprasellar meningioma - psammomatous type

Case contributed by Abdallah Al Khateeb
Diagnosis certain

Presentation

Occasional headaches.

Patient Data

Age: 55 years
Gender: Female

The suprasellar cistern is obliterated by a hyperdense, partially calcified mass lesion.

The sella turcica is preserved.

An irregular mass lesion centered at the suprasellar cistern, with a definite CSF cleavage from the pituitary gland. The mass is donating an iso-intense T1 and T2 signal, with diffuse solid enhancement on the post-Gd images.

Case Discussion

This mass shows the dural tail sign which is pointing to meningioma as the diagnosis. However, it is not pathognomonic.

The patient underwent trans-nasal and trans-sphenoidal excision.

HISTOPATHOLOGY:

Microscopy: reveals tumor consists of proliferation of spindle cells with eosinophilic cytoplasm and bland looking and monomorphic nuclei with occasional intranuclear inclusions. The spindle cells forming bundles of different thickness and interlacing in whorly fashion. Frequent psammomatous bodies are seen. No mitosis or necrosis. 

Diagnosis: meningioma, psammomatous type, WHO grade I. 

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