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Name of the Patient : Abc Xyzi S. Vyvalmn / F / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of diminished vision since 00.00.00.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
3 mm thick T1 Weighted and T2 Weighted coronal images.

A cisternogram was obtained in the sagittal plane.

PATIENT REFUSED CONTRAST ADMINISTRATION.

OBSERVATION :

There is seen a well-marginated, lobulated approximately 3.3 x 2.7 x 2.7 cms sized extra-axial mass lesion located in the suprasellar cistern in the suprasellar-retrosellar and retro-suprachiasmatic region. This lesion is predominantly hypointense on the T1 Weighted images and appears hyperintense on the T2 Weighted images. Few strands/septae are noted within this lesion. There is extension of the lesion posteriorly into the interpeduncular cistern with resultant splaying of the cerebral peduncles bilaterally. The optic chiasma and the optic tracts are stretched by the lesion. Superiorly the lesion is seen to indent the hypothalamus and the anterior third ventricular region. The third ventricle is displaced to the left of the midline. Laterally this lesion extends upto the medial temporal pole on either side. There is no extension of the lesion into the sella per se. The tip of the basilar artery is noted along the postero-lateral margin of the lesion (scans 103.8) and the posterior cerebral arteries are in close proximity to the lesion.
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There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter bilaterally. These lesions are isointense to normal white matter on the T1 Weighted images.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

IMPRESSION :

A well-marginated, approximately 3.3 x 2.7 x 2.7 cms sized extra-axial mass lesion in the suprasellar cistern in the suprasellar-retrosellar and retro-suprachiasmatic region with signal characteristics and extensions as described is not specific for a single etiology. This most likely represents an epidermoid tumor.

The possibility of this lesion representing a craniopharyngioma or a hypothalamic glioma seems less likely.

Patient refused a contrast study.
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