Female, 17 years old, with headache, with suprasellar mass and to recent hemorrhages, assess for changes or recurrent bleeding. A uniformly T1 and T2 hyperintense lesion within the sella has decreased in size when compared to the prior examination. It now measures 6 mm in height, previously 8 mm. As before, the lesion itself does not enhance but there is normal enhancement of the native pituitary gland which appears to drape over this lesion. The pituitary stalk continues to sit at midline and enhances normally. No impingement of the optic apparatus is seen.A small focus of gray matter heterotopia along the right frontal horn is unchanged. Otherwise, assessment of the brain is unremarkable. No areas of edema or mass effect are seen. No pathologic parenchymal or extra-axial enhancement is observed. No acute hemorrhage is seen and there are no abnormal extra-axial collections. The ventricular system is normal in size and morphology. Paranasal sinus mucosal inflammation is seen.
1.Interval decrease in size of a T1/T2 hyperintense presumably cystic lesion within the sella. The differential diagnosis remains as Rathke cleft cyst or cystic adenoma with proteinaceous or hemorrhagic contents.2.Stable focus of gray matter heterotopia along the right frontal horn. Otherwise, unremarkable evaluation of the brain.