Suprasellar Germinoma

Clinical History: 
This 24-year-old woman presented clinically with ongoing intermittent headaches most severe in the frontal region. On physical exam, she was found to have bilateral optic atrophy and a right homonymous hemianopia. The patient was noted to have a mass on subsequent CT and MRI examinations. She underwent a frontal temporal biospy of the mass which pathologically confirmed the presence of a germinoma.

Suprasellar germinoma.

MR Technique: 
Scans were acquired on a 1.5 T Siemens MR unit. (A) Sagittal pre-constrast spin echo T1-weighted (TR/TE 425/14 ms, scantime 4:32 min:sec) images as well as (B) coronal turbo spin echo T2-weighted (TR/TE 4000/95ms, scantime 2:20 min:sec) images were obtained, in addition to (C) sagittal postcontrast spin echo T1-weighted images. The slice thickness was 3 mm in each instance.

Imaging Findings:
There is a multilobulated mass with epicenter in the suprasellar cistern that appears to extend into the posterior pituitary gland, measuring up to 3.2 cm in greatest dimension. This results in associated mass effect upon the optic chiasm. The identified mass is isointense to gray matter on unenhanced T1-weighted images. On T2-weighted images, the mass demonstrates heterogeneous signal intensity with some areas brighter, hyperintense regions. The lesion enhances heterogeneously on post-contrast images.