Pituitary macroadenoma

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Headache and bitemporal hemianopsia.

Patient Data

Age: 55 years
Gender: Female
mri

Large sellar/suprasellar mass lesion displays intermediate T1 signal and a little hyperintense in T2 signal with internal cystic changes and moderate enhancement.

Extensions and mass effect:

  • laterally, it is encasing the right internal carotid artery and partially encasing the left internal carotid artery at the cavernous sinus bilaterally
  • inferiorly, expanding the sellar cavity and protruding into the sphenoidal sinuses
  • superiorly, it is markedly compressing the optic chiasm and both optic tracts and floor of 3rd ventricle 

Case Discussion

MRI demonstrating features consistent with a pituitary macroadenoma.

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