E5386. Differential Diagnosis of Suprasellar Masses, Imaging Findings, and Clinical Correlation
Authors
Angela Kanna;
Tufts Medical Center
Neel Madan;
Brigham and Women's Hospital/_Mass General Brigham
Background
Suprasellar masses are a common finding, and differential considerations are broad and include neoplastic, vascular, congenital, or infectious/inflammatory etiologies. However, specific imaging features can help tailor the differential diagnosis. Masses in this region may be clinically silent and discovered incidentally, or cause headaches and visual disturbance due to mass effect, as well as endocrine dysfunction. Discussion with the referring clinician, and clinical correlation can further refine the differential diagnosis.
Educational Goals / Teaching Points
Differential diagnosis of suprasellar masses. Classic imaging findings of common and uncommon lesions, with an emphasis on features that distinguish these lesions. Clinical correlation and the importance of communication between the radiologist and referring physician.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Contrast-enhanced MRI is the imaging modality of choice to characterize suprasellar masses, with MR or CTA imaging if indicated as well. The anatomic location lends itself to both endocrine complications and vision changes due to mass effect on the optic chiasm, and the involvement of local anatomic structures must be described and may be used to guide the differential diagnosis as well. The classic imaging appearance of common and uncommon neoplastic, inflammatory/infectious, vascular, and congenital lesions will be discussed, along with classic clinical presentations.
Conclusion
Suprasellar masses are a common finding, with the radiologist having an essential role in guiding diagnosis and therefore management of the patient. Specific imaging features can help tailor the differential diagnosis, and discussion with the referring clinician and clinical correlation can further refine the differential diagnosis.
