Solid and enhancing pituitary region mass

Dr Owen Kang and A.Prof Frank Gaillard et al.

Solid lesions with enhancement is by far the most commonly encountered appearance of pituitary region masses. The differential includes: 

  • macroadenoma
    • by far the most common entity
    • typically enhances less vividly than other entities
    • elevates the dura of the diaphragma sella (as the origin is within the pituitary)
    • the sella is expanded and remodelled
    • non normal pituitary tissue is usually visible
  • pilocytic astrocytoma
    • children 
    • enlarged optic chiasm or nerve
    • variable enhancement
  • craniopharyngioma
    • papillary subtype is more frequently solid, although cystic components are still more common than entirely solid lesions
    • epicentre is in ~85-95% of cases in the suprasellar region 1
    • in ~20% of cases there is extension into the pituitary fossa 1
  • meningioma
    • epicentre is usually outside the pituitary fossa
    • dural tail common
    • enhancement is homogeneous and vivid
    • if the carotid is encased, then it is usually narrowed
  • metastasis
    • uncommon
    • irregular margins
    • may have erosion / destruction of bony margins without expansion (rapid rather the slow growth)
  • inflammation / infiltration
  • germinoma
    • usually paediatric population
    • often involves inferior recesses of third ventricle
    • often also involves pineal region
  • pituicytoma
  • granular cell tumour of the pituitary (pituitary choristoma)

See also

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Article information

rID: 17390
Section: Gamuts
Synonyms or Alternate Spellings:
  • Pituitary region mass with solid enhancement

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Cases and figures

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    Case 1: meningioma
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