Pituitary macroadenoma

Case contributed by Dr Mostafa El-Feky

Presentation

Known patient with pituitary macroadenoma, on medical treatment of hyperprolactinemia for one year.

Patient Data

Age: 30 years
Gender: Female
MRI

Brain and sella

A sizable sellar and suprasellar mass lesion expanding the sellar cavity, measuring 15 x 19 x 19 mm at its largest dimensions. It is displayed homogeneous isointense signal with post-contrast intense homogeneous enhancement.

It is displacing the cavernous sinus and both internal carotid arteries laterally. It is encroaching upon the suprasellar cistern compressing the optic chiasm. Deviated pituitary stalk to the right.

Dehiscence of the dorsum sellae as well as the posterior walls of both sphenoid sinuses.

Case Discussion

MRI study of a known patient with pituitary macroadenoma, on medical treatment of hyperprolactinemia for one year, came for follow up of pituitary size which revealed a stationary size, the previous study is not shown. 

The MRI features are consistent with pituitary macroadenoma, with snowman appearance of the expanded pituitary gland. It shows thin mantle of homogenously enhancing rim which may represent the stretched pituitary glandular tissues. It is expanding the sellar cavity and encroaching upon the suprasellar cistern.

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Case information

rID: 68105
Published: 17th May 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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