D.D. of supra sellar lesions

The most common lesions affecting supra sellar area can be classified according to the age of the patient,

is it adult or a child.

 

The most common lesions affecting this area in adult are

 

-Meningioma or

-Pituitary macro-adenoma.

 

Simply meningioma affect mainly females with characteristic dural base position and evidence of dural tail with homogenous enhancement.

 

While the pituitary macro-adenoma characterized by its heterogenous enhancement with being a lesion starting in the sellar area then extends to supra sellar area. 

 

While the most common lesions in childhood are

 

-Craniopharyngioma(50%) or

-Hypothalamic glioma(25%).

 

Craniopharyngioma consists of a complex structure forming of a cystic part, solid part and calcification while hypothalamic glioma shows homogenous enhancement.

 

Less common lesion which could be classified according to density of the lesion

 

Cystic lesion such as arachnoid cyst, epidermoid cyst or colloid cyst.

 

Fatty lesion such as lipoma, dermoid and tuber cenerium teratoma

 

or soft tissue lesion such as germinoma, metastases or other types 

 

of glioma seen in this region.