Pituitary macroadenoma

Case contributed by Juan Carlos Santizo Castillo
Diagnosis almost certain

Presentation

Chronic headache, mild vision loss, galactorrhea, and fatigue.

Patient Data

Age: 55 years
Gender: Female
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Coronal C+
arterial phase
This study is a stack
Sagittal C+
arterial phase
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Info

CT images show a large mostly solid mass with some cystic areas is seen arising from the sellar fossa that looks expanded.  The mass is seen extending to the suprasellar cistern, compressing the base of the frontal lobe, hypothalamic region, optic chiasm, and abutting the floor of the third ventricle. The lesion shows moderate enhancement and encases both carotid arteries and the left middle cerebral artery.

Case Discussion

Imaging findings suggestive of pituitary macroadenoma. Differential diagnosis includes; pituitary carcinoma, metastasis, or papillary craniopharyngioma. Sometimes they can be indistinguishable on imaging.

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