An Unusual Cystic Sellar-Suprasellar Mass in a Young Female

Authors

  • Cristina V. Jaring Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila Tel: 09178659771, 09228448180
  • Frances Lina C. Lantion-Ang Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila

Abstract

This is the magnetic resonance image (MRI) of the brain of a 23-year-old female with a 20-month history of headache, progressive blurring of vision, somnolence, constipation, cold intolerance and amenorrhea. Physical examination showed bitemporal hemianopsia and decreased muscle stretch reflexes for all extremities. She had normal serum sodium and urine specific gravity, modest elevation of prolactin level, low thyroxine level with inappropriately normal thyrotropin (secondary hypothyroidism), and markedly decreased 8 AM serum cortisol. The MRI of the head with gadolinium showed a moderate-sized peripherally enhancing sellar and suprasellar cystic mass measuring 3.3 x 3.6 x 4.0 centimeters which is partly hemorrhagic or containing proteinaceous material, that causes marked compression of the overlying optic apparatus. Imaging findings are most compatible with a craniopharyngioma.

 

Figure 1. Sellar mass exhibiting  pre-existing internal  T1 hyperintensity and evidence  of  sedimentation leveling. 

Figure 2. The sellar mass is asymmetric  towards the left, extending to the left cavernous sinus region.  It causes mild to moderate expansion of the floor of the sella.

                                                                                                                                                                                                            

 This is the magnetic resonance image (MRI) of the brain of a 23-year-old female with a 20-month history of headache, progressive blurring of vision, somnolence, constipation, cold intolerance and amenorrhea. Physical examination showed bitemporal hemianopsia and decreased muscle stretch reflexes for all extremities. She had normal serum sodium and urine specific gravity, modest elevation of prolactin level, low thyroxine level with inappropriately normal thyrotropin (secondary hypothyroidism), and markedly decreased 8 AM serum cortisol. The MRI of the head with gadolinium showed a moderate-sized peripherally enhancing sellar and suprasellar cystic mass measuring 3.3 x 3.6 x 4.0 centimeters which is partly hemorrhagic or containing proteinaceous material, that causes marked compression of the overlying optic apparatus. Imaging findings are most compatible with a craniopharyngioma.

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References

Choi SH, Kwon BJ, Na DG, et al. Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: Differentiation using MRI. CIlinical Radiology 2007; 62: 4553-462.

Bobustuc GC, Groves MD, Fuller GN, et al. Craniopharyngioma. http://emedicine.medscape.com/article/1157758.

Jameson L, De Groot L. Endocrinology–Adult and Pediatric, 6th ed. Saunders 2010.

Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology, 11th ed. Saunders 2008.

Published

2014-05-21

How to Cite

Jaring, C. V., & Lantion-Ang, F. L. C. (2014). An Unusual Cystic Sellar-Suprasellar Mass in a Young Female. Journal of the ASEAN Federation of Endocrine Societies, 26(1), 73. Retrieved from https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/2

Issue

Section

Images in Endocrinology

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