Presentation
Left optic nerve atrophy on the ophthalmological exam.
Patient Data
The MRI sequences demonstrate a sellar and suprasellar soft tissue mass with a suprasellar epicenter. It shows an intermediate signal intensity on T1WI and T2WI with intense and homogeneous enhancement on postcontrast sequences. The suprasellar component compresses the optic chiasma mainly its left lateral portion with an abnormal thinning of the left optic nerve as compared to the right side. The pituitary gland is well-visualized on all sequences with homogeneous enhancement. The pituitary stalk is displaced posteriorly. On sagittal postcontrast sequences there is a dural tail sign at the anterior margin of the mass, and on the coronal sequences, the dura of the diaphragm sella is displaced inferiorly, indicating the suprasellar origin of the mass. This mass encases partially the supraclinoid portion of both carotid arteries, with no significant reduction of their caliber on MRA sequence.
Case Discussion
This case demonstrates the MRI features of a tuberculum sellae meningioma.
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