Presentation
Elevated prolactin (1900 mcg/L - normal for non-pregant women = 4-23 mcg/L)
Patient Data
A 5mm area of persistent delayed enhancement lies in the right side of the pituitary gland. The infundibulum is displaced to the left. No significant suprasellar component and no cavernous sinus extension. The sellar floor is unremarkable and carotid flow voids are normal.
Conclusion: Right pituitary microadenoma
The patient was started on bromocriptine and prolactin levels rapidly normalized.
The pituitary now appears normal in size. The infundibulum is now midline and no persistent hyperenhancement can be identified. Note: the central base of skull is a little asymmetric resulting in the right side being higher.
Case Discussion
A good example of the importance of T1 C+ dynamic sequence in the diagnosis of microadenomas.
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