Pituitary adenoma - necrotic
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Large sellar/suprasellar mass with intrinsic high T1 signal, cystic signal change and post contrast enhancement is present extending into both cavernous sinuses. An extra-axial CSF space in the left middle cranial fossa presumably represents an arachnoid cyst although it has been incompletely visualised. No evidence of prior surgery or gliosis.
The patient went on to have a debulking incomplete resection.
Sections show fragments of pituitary adenoma: tumour cells are arranged in trabeculae, acinar structures and diffuse sheets. Immunohistochemical studies show negative immunoreactivity for ACTH, GH, LH, FSH, TSH and prolactin.
Final diagnosis: Pituitary adenoma, null cell type.