Presentation
Visual field defects.
Patient Data
Large homogeneously enhancing mass enlarges the pituitary fossa and compresses the optic chiasm.
Note is made of an expanded pituitary fossa with a narrowed AP diameter of the pituitary sphenoid sinus. Polyps or mucous retention cysts are present in both maxillary antra with fluid and mucosal thickening in the left ethmoid air cells.
MICROSCOPIC DESCRIPTION: The sections show a moderately cellular pituitary adenoma comprising sheets and nests, surrounded by vascularised stroma. The tumour cells have mildly enlarged round nuclei, finely granular chromatin and moderate amounts of eosinophilic cytoplasm. They infiltrate into the adjacent fibrous tissue, which could be dura. No normal anterior pituitary gland tissue is present. About 75% of the tumour cells are FSH positive. The Ki-67 index is about 3%. Immunostains for the other pituitary hormones are negative.
DIAGNOSIS: Pituitary tumour: "Invasive" silent gonadotroph cell adenoma.