Differential Diagnosis of Suprasellar Tumors in Children

Abstract

In contrary to the adult age the most common suprasellar tumors in children are with decreasing frequency craniopharyngiomas, chiasmatic/hypothalamic low-grade gliomas, germinomas and lesions attributable to a Langerhans cell histiocytosis. For differential diagnostic purposes also the rare hypothalamic hamartoma and meningeal metastases in the infundibular recess of the third ventricle are included. The typical aspects of the various tumors on computed tomography (CT) and magnetic resonance imaging (MRI) together with important clinical differences are illustrated. On the basis of imaging results and clinical symptoms differential diagnosis between the various tumor entities should be feasible in many cases. Of course, only in strictly defined cases like typical chiasmatic/hypothalamic and optic pathway gliomas or bilocular germ cell tumors a histological confirmation is dispensable.

Zusammenfassung

Im Gegensatz zu den histologischen Entitäten bei Erwachsenen finden sich bei Kindern in der suprasellären Region am häufigsten nach absteigender Häufigkeit geordnet Kraniopharyngeome, meist niedriggradige Gliome des Chiasma/Hypothalamus, Germinome und Hypophysenstielläsionen im Rahmen einer Langerhanszell-Histiozytose. Aus Gründen der Differenzialdiagnose wurden zusätzlich die seltenen hypothalamischen Hamartome und meningeale Metastasen im Recessus infundibularis des dritten Ventrikels mit aufgeführt. Das typische Erscheinungsbild dieser Tumoren in der Computertomographie (CT) und Magnetresonanztomographie (MRT) wird zusammen mit wichtigen klinischen Parametern dargestellt. Auf dieser Basis sollte eine differenzialdiagnostische Einordnung der meisten Tumoren dieser Region möglich sein. Nur bei typischen Chiasmahypothalamus- oder Sehbahngliomen und bilokulären Keimzelltumoren kann auf eine histologische Sicherung der Tumorart verzichtet werden.

Key words

Suprasellar tumor - brain tumor - children - CT - MRI

Schlüsselwörter

Supraselläre Tumoren - Hirntumoren - Kinder - CT - MRT

References

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