Sellar region masses

Question 1

Pituitary adenoma

Answer 1

hypoenhancing
micro - most common is prolactinoma
macro - expands sella turcica
hyperdense on CT
Hypointense on T2

Question 2

Craniopharyngioma

Answer 2

Adamantinomatous (children)
cystic (90%) calcs (90%)
solid or nodular enhancement
Papillary - older
Solid enhancing mass

Question 3

Rathke cleft cyst

Answer 3

Cystic
often has proteinaceous fluid
no solid/nodular enhancement

Question 4

Arachnoid cyst

Answer 4

thin walled cyst -
no enhancement

Question 5

Epidermoid vs Dermoid cyst

Answer 5

Epidermoid = lobulated, follows CSF signal, more lateral, hyperintense on DWI and restricted diffusion

Dermoid cyst - more central
Fat density on CT and MRI
no enhancement