Pituitary cystic lesion

Case contributed by Dr Hidayatullah Hamidi

Presentation

Primary infertility and galactorrhea

Patient Data

Age: 25 years
Gender: Female
MRI

A well-defined abnormal signal intensity mass lesion (hyperintense on T2WI, isointense on T1WI, without post contrast enhancement) in the right half of pituitary gland measuring 10 x 10 x 12 mm in size. No invasion of adjacent infiltrative or inflammatory changes.

Case Discussion

The differential diagnosis of above features can be cystic pituitary adenoma and rathke cleft cyst. 

In a study on differentiation between cystic pituitary adenomas and rathke cleft Cyst, M. park et. al concluded that presence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, and an off-midline location are more common with pituitary adenomas, while an intracystic nodule is more common in Rathke cleft cysts.

Here in this case; the off-midline location is in favor of adenoma while absence of septation, fluid-fluid level and hypointense rim make the possibility of Rathke's cleft cyst more likely.

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Case information

rID: 63624
Published: 11th Oct 2018
Last edited: 14th Oct 2018
Inclusion in quiz mode: Included

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