Pituitary macroadenoma

Case contributed by Bahman Rasuli
Diagnosis certain


Patient presenting with headache and visual disturbance.

Patient Data

Age: 35 years
Gender: Male

There is a 30*40*45 mm large heterogeneous enhancing mass lesion enlarging the pituitary fossa and extending to suprasellar cistern suggestive for pituitary macroadenoma. The solid mass also shows cystic and fatty components. No evidence of intratumoral hemorrhage also is seen.

Suprasellar extension of the mass causing to severe pressure effect on the optic chiasma and compression of the pre-pontine cistern are seen. Mild pressure effect on the right cerebral peduncle also is seen.

Right parasellar extension of the mass touching right cavernous sinus and displacing the cavernous segment of the right ICA laterally also is seen.

Case Discussion

The mass was biopsied.

Microscopic description: Histology sections show lobules and nests of uniformed neoplastic epithelial cells in a richly vascularized stroma. The tumoral cells are round to polyhedral with uniformed round nuclei and granular eosinophilic cytoplasm. Less than one mitosis per 10 HPF is seen. Some of the cells show degenerative changes.

Diagnosis: Pituitary adenoma.

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