Suprasellar mass

Discussion:

This case illustrates a well-defined, solid-cystic, and vivid enhancing suprasellar tumor that spares the pituitary gland. In this age group the differential diagnosis depends on the location relative to the third ventricle.

If suprasellar (below the floor of the third ventricle) consider:

  • meningioma (favored)

    • epicenter is usually outside the pituitary fossa

    • dural tail common

    • enhancement is homogeneous and vivid

  • craniopharyngioma

    • papillary subtype is more frequently solid, although cystic components are still more common than entirely solid lesions

    • epicenter is in ~90% of cases in the suprasellar region 

If intraventricular (within the third ventricle) consider:

Although lymphoma could have this appearance on many sequences the low signal on DWI argues strongly against this.

Unfortunately follow up is not available.

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