Mahmoud Hsairi, Achraf Saidi, Samia Amar, Rachida Saouab, Mohammed Ennmer
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 7
Date of Publication: 2026/07/18
Background: Suprasellar meningiomas, encompassing those arising from the tuberculum sellae and planum sphenoidale, are critical skull base neoplasms that present formidable diagnostic challenges. Their presentation often mimics other sellar and suprasellar masses, notably pituitary macroadenomas. Precise radiological evaluation is paramount to establish the diagnosis through specific imaging biomarkers and to assess the critical involvement of the optic apparatus and parasellar vasculature. Case Presentation: A 59-year-old female presented with a progressive decrease in bilateral visual acuity. Dedicated magnetic resonance imaging (MRI) revealed a large extra-axial suprasellar mass. Sagittal contrast-enhanced T1-weighted imaging demonstrated avid, homogeneous enhancement with a prominent dural tail, causing severe superior elevation of the optic chiasm and inferior displacement of the normal pituitary gland into a non-expanded sella turcica (Figure 1). Furthermore, coronal T2-weighted sequences demonstrated lateral tumor extension with focal encasement and a marked reduction in the luminal caliber of the left internal carotid artery (Figure 2). Conclusion: This case underscores the indispensable role of targeted MRI in the differential diagnosis of suprasellar masses. Identifying key radiological features—such as sellar integrity, chiasmal compression, and arterial luminal narrowing—is fundamental for distinguishing meningiomas from macroadenomas and determining surgical resectability.
Suprasellar meningioma; Magnetic resonance imaging (MRI); Optic chiasm compression; Internal carotid artery encasement; Pituitary macroadenoma; Differential diagnosis.
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