recent mri of brain

[steph9803]

I was having weakness in my hands and was sent to a nerve specialist. He tested me for some things that came out negative so he went on to order an MRI of my spine and brain. The one of my brain came back as follows

Findings: There is a 2.0 x 1.2 x 2.0 cm mass in the suprasellar cistern which demonstrates intense increased signal on T1-weighted images and intermediate signal on FLAIR and T2-weighted images and no significant enhancement. The mass appears to be separate from the pituitary gland, and anterior and separate from the hypothalamus. The mass extends towards the right orbital apex and appears to partially encase the right supraclinoid carotid artery. The mass appears well circumscribed and there is superior displacement of the optic chiasm but no definite involvement of the optic chiasm or optic nerves.

Impression: 2.0 x 1.2 x 2.0 cm nonenhancing mass in the suprasellar cistern which appears to be separate from the pituitary gland, optic chiasm and hypothalamus as well as the internal carotid artery. The differential includes craniopharyngioma and epidermoid cyst. Less likely is a cystic glioma or cystic astrocytoma. CT scan of the sella turcica would be of benefit in further characterizing this lesion as the presence of calcifications or fat within the lesion may distinguish it as being a craniopharyngioma or epidermoid cyst.

How worried should I be? Is that big for the location? Doctor is sending me to a neurosurgeon, but has no clue how long it will take to get in there. I would really appreciate ANY advice at all...since I totally lost at this point.

Thanks,
Stephanie

[steph9803]

Thanks for the response. I had a CT Monday which leads them to believe its an epidermoid tumor. I'm having problems with my insurance and the only neurosurgeon in our area..so I guess what I'm still left wondering is..what is the most likely route for a surgeon in removing a tumor in this location? Also, my vision in my right eye has been getting progressively worse over the past year...could that be the reason why?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It would be difficult to explain the weakness in the hands based on the MRI findings, which is likely an incidental finding. Many people have suprasellar masses and may not realize it. They are classically benign, slow-growing tumors. I do agree that seeing a neurosurgeon is appropriate. The concern would be the compression on the surrounding structures (tissue, ventricles, etc) and preventing future damage.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.