Invasive pituitary macroadenoma

Case contributed by Ammar Haouimi
Diagnosis almost certain


Headaches with elevation of serum prolactin level.

Patient Data

Age: 30 years
Gender: Male

Large sellar and suprasellar mass with figure-eight configuration, filling the suprasellar cistern cistern with compression and upwards displacement of the optic chiasma. It elicits an iso-to low signal to the cortical grey matter on T1, an iso-to high signal on T2 with areas of cystic/necrotic change. The postcontrast sequences show a heterogeneous enhancement except for the areas of cystic/necrosis change in the suprasellar component. There is an extension to the sphenoid sinus as well as to the cavernous sinuses (Knosp grade 2: the tumor extends to the space between the intercarotid line and the lateral tangent).

Case Discussion

MRI features of a sellar mass with suprasellar extension, suggestive of an invasive macroadenoma, compressing the optic chiasma with extension into the sphenoid sinus and cavernous sinuses (Knosp grade 2).

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