dermoid skull base tumor

[steph9803]

I was looking for an opinion on the most recent MRI report I received. My Skull Base NS said he thinks it's time to operate and I feel pretty comfortable with him...just wanted to see if someone would take a look for me.

FINDINGS: There is a seller/suprasellar mass which appears separate from the pituitary gland, displacing the pituitary gland inferiorly and displacing the pituitary stalk posteriorly. This mass is of near fat intensity on precontrast T1 and T2 sequences. There is no definite enhancing component of the mass on postcontrast images. The pituitary itself appears to enhance homogenously without focal lesion. the mass is centered in the suprasellar midline, splaying the prechiasmatic optic nerves and supraclinoid ICA laterally. The mass extends laterally beneath and lateral to the right supraclinoid ICA. The mass measures approximately 16mm in greatest AP dimension x 13.8mm in craniocaudal dimension x 24.7mm in lateral dimension.

[Dr_Nassim]

yes do the surgery before the lateral dimension starts to attack the optic nerves.
But do your neurosurgeon means a transphenoidal approach? Or he proposed a low skull base?

[Dr_Nassim]

Yes, you are mostlly welcome, go for it finally it is a wise step plus I totally agree with the proposed approach for many reasons.
Be in touch
Medhelp Neurosurgeon is also happy that he could help in taking this decision :)

[steph9803]

Thank you for the response Doctor Chahine. I go next week to get into more detail about the surgery itself. It's out of town or we probably would have met again already. I found a Skull Base Neurosurgeon and went to see him as soon as I found out. He said he thinks a craniotomy would be the way to go because my pituitary gland (from MRI scan) would be an issue with the going through the nose...also that if I have a bleed it would be far easier for him to find and stop. I have had problems with bleeding in past surgeries.

Your answer has helped me feel more at ease with my decision, I really appreciate it.