Sunday, May 13, 2012

Suprasellar Mass in Adults: Differential Diagnosis #13

Today's Daily Diff is suprasellar masses in adults. The phrase SATCHMOE can be used to recall the diagnoses in this differential. Apparently, 'Satchmo' (without the 'e') was a nickname for jazz great Louis Armstrong. Some purists would omit the 'e' from the mnemonic, especially as eosinophilic granuloma is a form of Langerhans Cell Histiocytosis, which is already covered by the letter 'h'.

DiseaseNotes
SSuprasellar adenomaaka pituitary adenoma; enhances on MR
AAneurysmPulsation artifact on MR
TTeratoma
Seminoma

CCraniopharyngiomaArise from Rathke's cleft
Papillary form, age 40s
Typically calcified and cystic
HHistiocytosis
Hypothalamic glioma

MMeningioma
Metastases
Most common pituitary mets: breast, lung
OOptic glioma
EEosinophilic granuloma
Epidermoid 
Epidermis are DWI+

MR characteristics as well as age can be used to narrow the differential, but those features are beyond the scope of this post... which is a fancy way of saying I am too lazy to look all them up right now, but hopefully will update this at a later time. Or just check out the references below.

Pituitary macroadenoma
Source: Radiopaedia
References: