A 63-year-old male asked:
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i have a 4yo whose ct for trauma picked up a 4x5x8mm supra sellar mass that abuts the optic nerve, no clinical symptoms ?likely cause

4 doctor answers
Dr. Bruce J. Stringer
46 years experience Radiology
Craniopharyngioma?: Location and age suggest craniopharyngioma. These tumors are said to be symptomatic in the supra-sellar when they reach 3cm so the trauma scan may have been good luck. The kid should have MRI with and without contrast as well as ct w& w/o contrast, hopefully supervised by a neuroradiologist. Other lesions need to be ruled out. Neurosurgery will also need to be consulted.
Answered on Oct 4, 2017
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Dr. Bharat Bhavsar
40 years experience Diabetology
Sellar tumors: Pituitary adenoma (0.5–2.5%), arachnoid cyst; Sellar–suprasellar tumors and cysts: Craniopharyngiomas (6–9%), Rathke's cleft cyst, arachnoid cysts; Suprasellar tumors: Chiasmatic/hypothalamic glioma (4–8%), arachnoid cyst; Lesions of the stalk: Germ cell tumors (1–2%), histiocytosis X; Miscellaneous lesions: Hypothalamic hamartoma, metastatic lesions, PNET.
Apr 20, 2014
Dr. Vered Lewy-Weiss
A Verified Doctor commented
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Agree with Dr. Stringer. Craniopharyngioma most likely. Gliomas & germinomas,etc possible. Peds endo for pituitary eval also recommended.
Mar 20, 2013
Dr. Mandakini Patel
40 years experience Pediatrics
Brain mass: Suprasellar mass: is it vascular vs solid vs hemorrhagic?
Answered on Nov 27, 2017
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1 comment
Dr. Keshav Narain
28 years experience Retinal Surgery
Visual field would not be reliable test, but neurosurgery consult is critical. Sounds like CT picked up early phase of microadenoma which is initially asymptomatic and obviously not associated with the trauma. If truly asymptomatic it could be observed for a while. Even large pitiutary adenomas can be silent. On the other hand, it would be an easy case to do via transphenoidal. Neurosurg?
Apr 16, 2014
Dr. Zachary Levine
27 years experience Neurosurgery
Hamartoma: In a small child this might be a benign hypothalamic hamartoma or it could be a germinoma. There are a number of solid masses it could be. This should be evaluated with a contrast enhanced imaging study and formal visual fields, of possible in a 4 year old. Most likely the best management is serial imaging looking for growth or change.
Answered on Apr 21, 2019
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2 thanks
Dr. A Daniel Pinheiro
24 years experience ENT and Head and Neck Surgery
Suprasellar mass: An MRI with and without gadolinium would be helpful
Answered on Nov 27, 2017

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