Presentation
Bilateral visual loss.
Patient Data
A mass causing ballooning of the sella with a large suprasellar component. It has areas of T1 hyperintensities and fluid-fluid level, demonstrates blooming artefacts on T2* sequences representing intratumoral hemorrhage. It shows moderate enhancement post gadolinium administration. Compressive mass effect on the optic chiasm and the midbrain is noted. There is extension into the cavernous sinuses with vascular encasement on the left.
Case Discussion
MRI findings are consistent with pituitary macroadenoma with intratumoral hemorrhage.
Histology:
Histologic sections show fragments of neoplastic lesions composed of sheets, nests and cords of round to polygonal cells which have inconspicuous nucleoli, delicately stippled chromatin and moderately abundant cytoplasm. Cytologic atypia is uncommon and mitosis are rare.
Diagnosis: Pituitary adenoma.
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