Suprasellar germinoma


  • A 23-year old lady
  • No known medical illness
  • Presented with chronic headache.
MRI brain in sagittal T1(a), T1+contrast (b) and Coronal T1+contrast (c)

MRI findings:

  • A lobulated suprasellar mass (yellow arrows).
  • It has mixed cystic and solid components.
  • The lesion show marked enhancement after contrast administration.
  • There is no invasion into the pituitary fossa.
  • The pituitary gland is identified, normal in appearance and separated from the lesion (red arrow).

Diagnosis: Suprasellar germinoma (HPE proven)


  • Intracranial germinomas are a type of germ cell tumour
  • It is also known as dysgerminomas or extragonadal seminomas.
  • These lesions are predominantly seen in paediatric patients. Peak age of incidence is 10-12 years of age with 90% of patient being younger than 20 at the time of diagnosis.
  • They tend to occur in the midline either at the pineal region or along the floor of the third ventricle/suprasellar region.
  • Suprasellar germinoma is more frequently seen in female.
  • On CT, the lesion is slightly hyperdense compared to the adjacent brain with marked enhancement post contrast. Cystic components are found in up to 45% of cases.
  • MRI demonstrates a lobulated soft tissue mass; isointense to slightly hyperintense on T1 and T2-weighted images. It may have areas of cyst formation, hemorrhage, central calcification and have predilection to cause adjacent brain oedema. It shows vivid and homogenous enhancement post contrast.


Author: radhianahassan