Hemorrhagic pituitary macroadenoma

Case contributed by Ammar Haouimi


Hyperprolactinemia (351 ng/mL). No history of sudden headache or visual loss.

Patient Data

Age: 25 years
Gender: Female

There is a relatively well-defined right-sided lesion (14 x 12 x 10 mm) of the anterior pituitary with central hemorrhage of high signal on T1 and low signal on T2/T2*. Moderate heterogeneous enhancement is noted on postcontrast sequences. The pituitary stalk is of normal thickness and enhancement, mildly shifted to the left.

Case Discussion

MRI features most consistent with a hemorrhagic pituitary macroadenoma.

On imaging, the main differential diagnosis is a pituitary apoplexy but usually, patients present acute symptoms (sudden headache, visual loss +/- oculomotor palsies).

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