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Case 1. (A) Coronal T2 and (B) coronal T1 postcontrast. Intrasuprasellar cystic hyperintense tumor with small solid hypointense peripheric nodule.
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Magnetic resonance imaging (MRI) of the brain showed a cystic solid heterogeneous sellar mass with suprasellar extension, suggestive of CP or pituitary adenoma (Figs. 1 and 2).
Case 1. (A) Sagittal T1 precontrast and (B) sagittal T1 postcontrast. Sellar-suprasellar hyperintense cystic tumor with a thin peripheric solid component (A). Solid peripheric component slightly enhanced, cystic component remains hyperintense (B).
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Magnetic resonance imaging (MRI) of the brain showed a cystic solid heterogeneous sellar mass with suprasellar extension, suggestive of CP or pituitary adenoma (Figs. 1 and 2).
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Case 2. (A) Sagittal T2, (B) sagittal T1 precontrast, and (C) sagittal T1 postcontrast. Sellar-suprasellar solid cystic expansion process with predominance of cystic component hyperintense in T2, and a hypointense peripheric solid component (A). Cystic hyperintense in T1 (B). Solid peripheric component and retroclival dural tail slightly enhanced (C). Mass effect on optic chiasm.
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The MRI showed an expansive process of the sellar-suprasellar region, partially cystic, slightly heterogeneous, hyperintense on T1-weighted and heterogeneous in T2-weighted image with calcifications, mass effect on the optic chiasm, and a retroclival dural tail with contrast enhancement (Fig. 3).
(A) Hematoxylin-eosin technique, fibrous tissue is observed with xanthogranulomatous chronic inflammation. (B) Crystals of cholesterol, inflammatory cells, and macrophages.
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Histopathological examination showed the presence of cholesterol crystals, sclerosis and fibrosis of the connective tissue, cholesterol granulomas, lymphocytic infiltrate, hemosiderin deposits, and multinucleated giant cells without epithelial component, findings consistent with a xanthogranuloma (Fig. 4).
Case 2. Postoperative (A) sagittal T1 precontrast, (B) sagittal T2, and (C) sagittal T1 postcontrast. Lesion suggestive of residual tumor, smaller than preoperative. Solid cystic sellar expansive process. The anterior thin solid peripheral component shows slightly enhancement postcontrast and remaining retroclival dural tail.
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Postoperative MRI showed a heterogeneous residual tumor appearance with a remnant of the retroclival dural tail before mentioned (Fig. 5).
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Case 3. (A) Coronal T1 postcontrast and (B) sagittal T1 postcontrast. Intra- and suprasellar cystic tumor with small solid excentric extension, with predominance of T1 hyperintense cystic component, and a thin peripheral solid component which slightly enhanced postcontrast. Optic chiasm compression.
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Endocrinological evaluation showed panhypopituitarism and brain MRI showed a sellar mass contacting the optic chiasm (Fig. 6).