Huge prolactinoma

Case contributed by Dr Nikola Todorovic

Presentation

The patient was treated for years for "sinus problems". After the onset of worsening, with difficulties breathing and extensive nasal discharge, CT has been performed when heterogeneous selar mass has been identified.

Patient Data

Age: 70
Gender: Male
MRI

There is a huge, dominantly infrasellar mass in the left part of the sphenoid sinus, that erodes his posterior and lateral wall (no invasion and compression of the left ICA).

The lesion is approximately 26 x 18 x 21 mm (AP x CC x LL), with iso-signal intensity on T1W, with zones of hyper SI, hyper SI on T2W, with intense, inhomogenous postcontrast signal intensity enhancement.

The optic chiasm is free and looks regular.

Case Discussion

The patient has been sent for the pituitary MRI because of the mass that has been seen on the CT.

His prolactin level was 20000 mIU/L, and he had signs of the secondary hypogonadism.

He will be treated with bromocriptine and followed.

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Case information

rID: 56042
Published: 7th Oct 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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