Pituitary macroadenoma - cavernous sinus invasion
Adult patient presenting with a homonymous bitemporal hemianopia.
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MRI of the pituitary demonstrating a large mass extending into the suprasellar cistern and compressing the optic chiasm. Note the invasion into the left cavernous sinus with encasement of the ICA.
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This patient went on to have transphenoidal surgery.
Microscopic Description: Sections show pieces of a pituitary adenoma, and fragments of neurohypophysis. Focal microcysts are seen. The tumor cells are immunoreactive for growth hormone, and are immuno-negative for LH, TSH and FSH. Rare cells display immunoreactivity for ACTH and prolactin.
Final Diagnosis: Pituitary macroadenoma, showing growth hormone immunoreactivity.
This case demonstrates appearances of a sizable pituitary macroadenoma.