Pituitary macroadenoma

Case contributed by Dr Ian Bickle

Presentation

T2DM with discordant TFT. TSH-secreting pituitary adenoma?

Patient Data

Gender: Male
MRI

Well defined avidly enhancing mass in the anterior pituitary measuring 2.1 x 1.7 x 1.6cm, which displaces the posterior pituitary bright spot to the right. 

This abuts and mildly compresses the optic chiasm.  The intracavernous internal carotid arteries abut the mass laterally.

Normal infundibulum.

The remainder of the intracranial appearances are normal.

 

Pathology

Histological findings from operative specimens consistent with radiological appearances.

Case Discussion

Pituitary macroadenomas are the most common suprasellar mass in adults. Pituitary adenomas are lesions greater than 10 mm in size and are approximately twice as common as pituitary microadenomas.

Identifying the posterior pituitary bright spot is important to identify and mention in reports to avoid diabetes insipidus

This patient underwent a transsphenoidal hypophysectomy.

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