A case of suprasellar cystic lesion difficult to diagnose

Abstract

A 12-year-old boy. He realized that it was hard to see the outside with his left eye. A visual field test revealed bitemporal hemianopia, and head computed tomography (CT) and magnetic resonance (MR) images showed a tumor in the upper saddle. CT showing a tumor with simple cyst and without calcification in the suprasellar portion. MR images showed a solid tumor with high intensity on images of the T1-weighted imaging and iso-high intensity (forming niveau) on images of the T2-weighted imaging. The tumor not reinforced the uptake of the contrast agent. Because of visual field impairment, endoscopic nasal tumor resection was performed. When the dura mater was incised, xanthochromic cystic fluid flowed out vigorously, and a soft grayish-white tumor was found on the cyst wall, and these were removed. The pathological result was Densely granulated corticotroph adenoma (silent subtype 1). Silent corticotroph adenoma (SCA) like this case is rare among non-functional pituitary adenomas (NFA) in young people. This case is SCA, we need to continue to follow up carefully.