Figure 2: MRI with gadolinium enhancement of a 5-year-old girl. (a) Preoperative MRI show a huge suprasellar cystic gadolinium-enhanced mass lesion with lateral extension and hydrocephalus (left: axial, right: coronal section). According to the proposed new system, the tumor was grade IV (score: 3+3+1+1+0+2=10). (b) Postoperative MRI with gadolinium enhancement demonstrate apparently total removal of the tumor with small lacunae infarction (left: axial, right: coronal section).However, two years later, residual tumor was detected and additional gamma knife (GK) treatment was conducted. Five years after GK treatment until now, no recurrence has been detected both clinically and radiologically.