Invasive pituitary macroadenoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Headache and loss of sight.

Patient Data

Age: 50 years
Gender: Male
This study is a stack
Axial
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

A large mass is seen within sellar fossa and suprasellar cistern that causes ballooned sella and compresses the optic chiasm and floor of 3rd ventricle superiorly. Sellar floor andupper clivus and sphenoidal sinus are invaded by the mass.

This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Coronal
T2
This study is a stack
Sagittal
FLAIR
This study is a stack
Axial
T1 C+
This study is a stack
Coronal
T1 C+
This study is a stack
Sagittal
T1 C+
Download
Info

There is a large mass within sellar fossa and suprasellar cistern. The mass causes expansion of the sella and compresses the optic chiasm and floor of 3rd ventricle superiorly. Invasion of the mass to sellar floor and involvement of upper clivus and sphenoidal sinus are also present. The mass is isointense on T1W sequence and slightly hyperintense on T2, FLAIR sequences, enhanced homogenously on post contrast exam. Mild partial encasement of adjacent left ICA is detected.

Case Discussion

Features on CT scan and MRI are consistent with invasive pituitary macroadenoma.

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