MC, a 69-year-old female who following a head injury, was diagnosed with an incidental suprasellar cystic-solid mass. She remained asymptomatic for 4 years, subsequently developing diminished vision along with weight gain with an increase in lesion size. She underwent biopsy-aspiration of the cyst followed by Gamma Knife radiosurgery a month later. Subsequently 4 months later she developed a cyst recurrence on imaging and underwent Ommaya reservoir insertion, having no associated clinical changes. On follow-up, her MRI revealed an increase in the size of the cyst. Although further aspiration of the cystic component via the Ommaya reservoir was advised, she declined any intervention. Repeat imaging revealed a spontaneous decrease in the size of the cystic component that remained stable over time and required no further intervention.
MO, a 24-year-old male presented at an outside hospital with headaches of a few months in duration with a loss of libido and decreased energy levels. His endocrine workup revealed hypopituitarism and imaging showed a 2.5 cm sellar-suprasellar solid cystic mass for which he underwent a cyst aspiration and biopsy. He subsequently had tumor progression and was treated with GKRS. Long-term follow-up at 9 years continues with the patient remaining stable and requiring no further interventions.