Figure 1
figure 1
sagital mpr contrast-enhanced MDCT showing a suprasellar lesion with adipose and osseous components abutting the pituitary stalk and the tuber cinereum.
Suprasellar osteolipoma
SectionNeuroradiology
Case TypeClinical Cases
AuthorsDe Temmerman G. From the department of Radiology and Nuclear Medicine, Sint Andriesziekenhuis, Tielt, Belgium
Connected authors
55 years, female
Clinical History
A 55 years old woman presented to our ENT-department with pulsatile tinnitus which had been going on for many months. Otoscopy was normal as were the hearing tests. Her medical history was
unremarkable
Imaging Findings
The otorhinolaryngologist asked for a CT-angiography to rule out vascular malformations or temporal bone abnormalities. We performed a high resolution CT-scan after intravenous administration of
iodinated contrast material. We didn’t found any abnormality within the temporal bone or tympanic cavity. A vascular malformation wasn’t detected. But there was a heterogeneous mass
lesion within the suprasellar cistern abutting the pituitary stalk and the tuber cinereum of the hypothalamus. The lesion was made up of two different types of tissue, namely a fatty (mean -75 HU)
and an osseous component. Based upon the location and the attenuating characteristics the diagnosis of a suprasellar osteolipoma was made. We concluded that it was a coincidal finding and no
explanation for the pulsatile tinnitus.
Discussion
Osteolipomas originate from the mesodermal embryonal layer, they arise from remnants of the meninx primitiva or from the mesenchym of the craniopharyngeal duct. Their arrangement of central adipose
and peripheral osseous tissues distinguishes them from other intracranial lipomas at other locations. They typically arise between the pituitary stalk and the mammilary bodies abutting the tuber
cinereum of the hypothalamus and project into the suprasellar or interpeduncular cisterns. These lesions are almost always incidental findings on CT or MRI scans done for other reasons. Nevertheless
Bognar et al published a case in 2002 of a hypothalamic osteolipoma with associated endocrinological disturbances. These lesions usually do not need to be removed.
Differential Diagnosis List
Suprasellar osteolipoma
Final Diagnosis
Suprasellar osteolipoma
References
[1] Sinson G, Gennarelli TA, Wells GB. Suprasellar osteolipoma : a case report. Surg Neurol 1998 ;50(5) :457-60. (PMID: 9842872)
[2] Kikuchi K, Kowada M, Watanabe K. Computed tomography of an intracranial lipoma confined in the suprasellar cistern. Computed med imaging graph 1994;18(3):187-92. (PMID: 8025885)
[3] Bognar L, Balint K, Bardoczy Z. Symptomatic osteolipoma of the tuber cinereum. Case report. J Neurosurg 2002;96(2):361-3. (PMID: 11838812)
[4] Mackezie IR, Girvin JP, Lee D. Symptomatic osteolipoma of the tuber cinereum. Clin Neuropathol 1996;15(1):60-2. (PMID: 8998859)
Case information
| URL: | https://eurorad.org/case/4736 |
| DOI: | 10.1594/EURORAD/CASE.4736 |
| ISSN: | 1563-4086 |
Figure 2
figure 2
coronal mpr contrast-enhanced MDCT showing a suprasellar lesion abutting the tuber cinereum of the hypothalamus.
Figure 3
figure 3
axial mpr contrast-enhanced MDCT showing a suprasellar lesion with central adipose and peripheral osseous tissue.
figure 1
sagital mpr contrast-enhanced MDCT showing a suprasellar lesion with adipose and osseous components abutting the pituitary stalk and the tuber cinereum.
figure 2
coronal mpr contrast-enhanced MDCT showing a suprasellar lesion abutting the tuber cinereum of the hypothalamus.
figure 3
axial mpr contrast-enhanced MDCT showing a suprasellar lesion with central adipose and peripheral osseous tissue.