Patient presenting with bilateral shaking spells possibly reflecting seizure. Patient reported history of a midline tumor in the anterior brain. Questionable cystic lesion in the sella on recent CT. Evaluate mass. Motion artifact mildly limits evaluation.Similar to recent CT, there is a cystic appearance of the sella. The pituitary is small and displaced inferiorly within the sella. The hypothalamic stalk traverses the cystic space. Separate from the pituitary and stalk, there is a soft tissue nodule which sits along the anterior superior aspect of the cyst. No significant mass effect on the adjacent brain parenchyma, hypothalamus, and optic chiasm. No abnormal parenchymal signal is seen on the T2, FLAIR or diffusion weighted images. There is no evidence of intracranial hemorrhage or edema. The ventricles and basal cisterns are normal in size and configuration. The expected intracranial vascular flow voids are present. Partial opacification of the ethmoid air cells and right mastoid sinus mucous retention cyst, mild left maxillary sinus mucosal thickening. The visualized mastoid air cells are clear. The orbits are unremarkable.
Cystic lesion with associated soft tissue nodule within the sella with apparent mass effect which inferiorly displaces and flattens the pituitary gland. No definite/significant calcification is noted on recent CT. Within the limits of a noncontrast exam, these findings may reflect either a Rathke's cleft cyst or possibly a craniopharyngioma.