Presentation
Persistent headaches and visual complaints including photophobia and decreased acuity. Patient was found to have dense bitemporal hemianopsia on examination.
Patient Data
There is a sellar and suprasellar lobular T1 hyperintense mass (snowman sign). There is mass effect on the optic chiasm. There is rightward deviation of the pituitary infundibulum. The paraclinoid ICA flow void segments course along the lateral margins of this mass. There is no definite extension into the
cavernous sinuses.
Case Discussion
This is a case of a pituitary macroadenoma with an apoplexy event (not well visualised radiographically). The patient underwent an endoscopic endonasal pectoral approach for resection of a pituitary macroadenoma. Intraoperative pathology showed degenerated blood elements, inflammatory cells, rare benign epithelial cells, and benign bone. Final histopathology confirmed the intraoperative findings of a pituitary macroadenoma with acute and degenerated blood elements.
Co-author:
Morgan Zhao, MD
Daniel Gewolb, MD
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