Pilocytic Astrocytoma

Findings:

A complex cystic and solid suprasellar mass is associated with a nearly solid nodular component inseparable from the hypothalamus and splaying the third ventricle. The interior cystic portion contains fluid that is slightly hyperintense to CSF. No diffusion restriction is present within the mass. Normal pituitary tissue is seen within the sella, with an inferiorly buckled infundibulum. Subtle edema is present within the optic tracts right greater than left. The frontal horns of the lateral ventricles are dilated.

Differential Diagnosis/Discussion:

The differential diagnosis of a complex cystic and solid suprasellar mass includes craniopharyngioma and astrocytoma, with metastasis less likely. In this case, the mass is separate from the pituitary gland indicating that a pituitary adenoma is unlikely. The rim enhancement of the cystic portion is less than would be expected for craniopharyngioma.

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