Pituitary macroadenoma - cavernous sinus invasion

Case contributed by Frank Gaillard
Diagnosis certain


Adult patient presenting with a homonymous bitemporal hemianopia.

Patient Data

Age: Adult

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.

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.

Case Discussion

This case demonstrates appearances of a sizable pituitary macroadenoma. 

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