Pituitary apoplexy with pituitary macroadenoma

Case contributed by Anastasia Tjan
Diagnosis almost certain


Headache, decreased visual clarity, malaise, and weight loss. Clinically suspicious of a cerebral space-occupying lesion.

Patient Data

Age: 60 years
Gender: Female

A large well-marginated mass in the sellar region extends into the suprasellar region. Slightly heterogeneous but intense enhancement following IV contrast administration confirms the presence of a mass. Imaging appearances are highly suggestive of a pituitary macroadenoma.

The heterogenous T2 signal is likely to be due to internal hemorrhage.

Restricted diffusion is seen on the diffusion-weighted imaging. This is important as it has been reported as an early sign of pituitary apoplexy 1.

Case Discussion

Histology following resection demonstrated a pituitary adenoma.

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