Pituitary cystic lesion
Primary infertility and galactorrhea
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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.
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.
- Park M, Lee SK, Choi J, Kim SH, Kim SH, Shin NY, Kim J, Ahn SS. Differentiation between cystic pituitary adenomas and Rathke cleft cysts: a diagnostic model using MRI. American Journal of Neuroradiology. 2015 Aug 6.