Suprasellar epidermoid cyst

Radiologically, dermoid cysts typically present as low density masses on CT scan and are generally hyperintense on T1-weighted MRI sequences with variable signal on T2-weighted sequences. The recognition of atypical features can avoid diagnostic pitfalls and is clinically relevant for overall surgical management 1)

A 27-year-old woman suffered from multiple congenital defects, including transsphenoidal encephalocele. Recent progressive visual loss was at first attributed to this encephalocele, but was later proved to be caused by a suprasellar epidermoid cyst. Its removal was followed by improvement of vision. To the best of our knowledge, the association of basal encephalocele and epidermoid cyst has not been previously described 2).

1)
Tan LA, Kasliwal MK, Harbhajanka A, Kellogg RG, Arvanitis LD, Munoz LF. Hyperdense suprasellar mass: An unusual radiological presentation of intracranial dermoid cyst. J Clin Neurosci. 2015 Jul;22(7):1208-10. doi: 10.1016/j.jocn.2015.01.017. Epub 2015 Apr 10. PubMed PMID: 25865027.
2)
Sadeh M, Goldhammer Y, Shacked I, Tadmor R, Godel V. Basal encephalocele associated with suprasellar epidermoid cyst. Arch Neurol. 1982 Apr;39(4):250-2. PubMed PMID: 7073536.