Suprasellar meningioma

Case contributed by Dr Varun Babu

Presentation

Bitemporal hemianopia. History of resected suprasellar meningioma.

Patient Data

Age: 60 years
Gender: Female
MRI

30 x 28 x 25 mm (TR x AP x CC) suprasellar lesion extending anteriorly to planum, thinning and splaying optic chiasm, abutting and splaying both cavernous ICAs laterally. Displacement of the adenohypopophysis inferiorly. Mild gliosis of posterior margin of right olfactory gyrus with vasogenic edema. Lesion is slightly T1 hypointense, T2 hyperintense and shows intense contrast enhancement. No cavernous sinus invasion.

Normal posterior pituitary T1 bright spot. Normal morphology and signal intensity of adenohypophysis. Central pituitary stalk. No focal lesions.

Bilateral centrum semiovale, periventricular white matter, right posterior putamen and ventrolateral pons chronic small vessel ischemic changes.

No acute infarct. No extra axial or intra axial hemorrhage.

Thalami are normal. Ventricles and basal cisterns are normal.

Midbrain, medulla and cerebellum are normal. Orbits and paranasal sinuses are normal.  

No abnormal meningeal enhancement.

Conclusion

  • suprasellar / planum sphenoidale intensely enhancing mass lesion with mass effect as described, likely suprasellar meningioma

  • bilateral centrum semiovale, periventricular white matter, right putamen, ventrolateral pons chronic small vessel ischemic changes

Case Discussion

Suprasellar meningioma resected 5 years ago, with symptoms and imaging features strongly favoring recurrence 5 years later.

Meningioma has to be high in your differentials of solid enhancing suprasellar lesions that are isointense grey matter on all pulse sequences.

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Case information

rID: 61788
Published: 19th Jul 2018
Last edited: 19th Jul 2018
Inclusion in quiz mode: Included
Institution: Vivid Diagnostic Centre

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