Presentation
Dimness of vision.
Patient Data
There is enlargement of sella with a large well-defined lobulated mass lesion within the sella and extending into supra-sellar region, measuring approximately 3.7 (SI) x 3.4 (AP) x 3.1(TR) cm size. The pituitary gland and infundibular stalk are not separately identified from the lesion. Superiorly the lesion is compressing the optic nerves and optic chiasma. Inferiorly the lesion is causing thinning of floor of the sella with extension into sphenoid sinus. Laterally, the lesion is mild extending into right cavernous sinus and abutting the cavernous segment of right internal carotid artery.
The normal hyperintensity of the posterior pituitary gland is visualized on the T1W images in the posterior aspect of lesion.
Case Discussion
These case most likely represents a pituitary macroadenoma.
The other unlikely differential diagnosis is a meningioma.
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