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BACKGROUND: Incidental findings pose a dilemma in aviation medicine, where every finding must be carefully considered in order to ensure the well-being of the aircrew for flight and mission safety. Since suprasellar masses are not uncommon, their possible effects should be addressed.CASE REPORT: We present an incidental finding of 11.5 mm × 14.4 mm, hyper-intense on T2 and iso-intense on T1-weighted images, of a suprasellar mass in a 19-yr-old man. This finding led to the re-evaluation of his position as a military flight cadet, followed by his later disqualification.DISCUSSION: No medical waiver regarding asymptomatic suprasellar mass exists. We have carefully examined the differential diagnosis and generated a profile for each possible diagnosis consisting of risks for sudden incapacitation, progression likelihood, and the effect of an aerial environment on a brain lesion. We were able to draw up a medical waiver for some of the possible diagnoses (namely, Rathke’s cyst or craniopharyngioma) for nonhigh performance aircraft.Doron O, Carmon E. An incidental suprasellar mass in a military flying cadet: implications for aircrew. Aerosp Med Hum Perform. 2015; 86(5):477–480.

Keywords: military flying cadet; medical waiver; suprasellar mass; aviation medicine; craniopharyngioma; Rathke’s cleft cyst; low grade glioma; hypothalamic hamartoma
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