Young Man With a History of Headaches and Blurred Vision


A healthy 24-year-old male presented with a history of several months of poorly localized headaches and blurred vision. Evaluation by an ophthalmologist detected the presence of bitemporal hemianopsia. MRI of the brain demonstrated a multi-lobulated mass with both cystic and solid components causing significant superior displacement of the optic chiasm. The patient subsequently underwent a subtotal resection.

The T1-weighted post-contrast image (top left), and the T2-weighted images (top right, bottom left and right) are shown here.

Based on the radiographic appearance of the mass, what is the most likely diagnosis?

A. Pituitary adenoma
B. Craniopharyngioma
C. Atypical meningioma
D. Primary CNS Lymphoma