MR findings of Rosai-Dorfman disease in sellar and suprasellar region

Background: Rosai-Dorfman disease (RDD) in sellar/suprasellar region is a rare intracranial disorder. The diagnostic evaluation of this condition using magnetic resonance imaging (MRI) has seldom been described previously. The purpose of our study was to describe MRI characteristics of sellar/suprasellar region RDD.

Methods: Five patients with proved sellar/suprasellar region RDD from May 2005 to March 2010 were retrospectively reviewed. All the patients had undergone magnetic resonance scanning. The number, location, signal intensity (SI), and enhancement pattern of the lesions on MRI were retrospectively evaluated.

Results: Pathological diagnosis of RDD was achieved in all 5 cases including 4 by surgery and 1 by biopsy. The most common presenting symptoms were headache (n = 4) and blurred vision (n = 3). On MRI, isolated suprasellar lesion was found in 2 cases. Suprasellar lesion combined with intrasellar, dural, intra-axial and orbital lesions was found in 3 cases. All lesions showed homogeneous isointense SI on T1-weighted images and hypointense to isointense SI on T2-weighted images except one lesion in the midbrain with slight hyperintense SI on T2-weighted images. All lesions showed homogeneous enhancement.

Conclusion: Homogenously enhancing sellar/suprasellar masses of hypointense to isointense SI on T2-weighted images are suggestive of RDD, and central hypointensity on T2-weighted images may be a specific finding. Intra-axial and extra-axial involvements may coexist with sellar/suprasellar region RDD. Although radiological findings can provide some evidence for this rare entity, differential diagnosis is still needed.