Suprasellar pilocytic astrocytoma

Case contribution: Dr Radhiana Hassan


  • A 4 years old girl
  • Presented with vomiting after a fall
  • Urgent CT scan shows a mass lesion at sellar region
  • Referred for further investigation and management
MRI of brain in axial planes T1WI, T2WI and T1-post gadolinium
MRI in coronal planes T2-weighted and T1-post gadolinium images
MRI brain in sagittal planes T1-weighted and T1-post gadolinium.

MRI findings:

  • A well-defined mass lesion at suprasellar region (yellow arrows)
  • It shows mixed signal intensity and predominantly solid
  • Vivid enhancement of solid component is seen
  • No intralesional calcification or hemorrhage
  • Sella and pituitary is normal
  • No abnormal meningeal/dural enhancement

Diagnosis: Pilocytic astrocytoma (HPE proven)


  • Pilocytic astrocytoma at sella/suprasella region is known as optic pathway glioma
  • It typically present in children, accounting for 10-15% of supratentorial tumors in this age group
  • Males and females are approximately equally affected
  • In adults, optic nerve gliomas do occur but are very rare and usually aggressive tumors
  • Association with NF 1 in 10-63%
Author: radhianahassan