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Suprasellar Cystic Lesions
A 19-year-old woman presenting with chronic visual changes, amenorrhea, and weight gain. Ax, axial; CT, computed tomography; DWI, diffusion-weighted imaging; Sag, sagittal.
A 70-year-old woman presenting after sustaining trauma. Ax, axial; CT, computed tomography; DWI, diffusion-weighted imaging; Sag, sagittal.
A 41-year-old man presenting with headaches. Ax, axial; CT, computed tomography; DWI, diffusion-weighted imaging; Sag, sagittal.
A 19-month-old boy with anisocoria. Ax, axial; DWI, diffusion-weighted imaging; Sag, sagittal.
A 60-year-old woman with a history of left tonsil squamous cell carcinoma and a sellar/suprasellar lesion incidentally noted on a neck computed tomography scan. Ax, axial; Cor, coronal; DWI, diffusion-weighted imaging; Sag, sagittal.
DESCRIPTION OF FINDINGS
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Case A: A predominantly cystic suprasellar mass with marked T2 hyperintensity and without associated restricted diffusion. A sagittal postcontrast fat-saturated image demonstrates an irregular, mildly thickened, and mildly nodular rim of enhancement. Close inspection of the axial CT image demonstrates a few associated peripheral punctuate calcifications that are most prominent anteriorly.
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Case B: A suprasellar, ovoid, smoothly contoured, homogeneous, CSF isointense cystic lesion with a thin rim of peripheral enhancement. No associated calcification is noted.
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Case C: A suprasellar, nonenhancing, lobulated, cystic-appearing suprasellar mass mildly hyperintense to CSF on T1-weighted images, slightly hypointense to CSF on T2-weighted images, and markedly hyperintense to CSF and brain parenchyma on DWI.
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Case D: A suprasellar, nonenhancing, smooth-walled, CSF isointense cystic lesion distorting the infundibulum without associated restricted diffusion.
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Case E: A sellar/suprasellar, noncalcified, ovoid, smoothly contoured, nonenhancing, cystic lesion with intrinsically T1 hyperintense and T2 hypointense homogeneous signal suggesting proteinaceous contents. T2 images demonstrate a hypointense intracystic module.
Diagnosis
Case A
Craniopharyngioma
Case B
Rathke cleft cyst
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