Pituitary macroadenoma invading the cavernous sinus

Case contributed by Dr Chris O'Donnell

Presentation

Deterioration in mental function with possible stroke, ? vascular lesion

Patient Data

Age: 90
Gender: Female

Mass lesion arising in the pituitary fossa extending on the left side into and expanding the cavernous sinus, encasing the distal left internal carotid artery (arrow).  Note the cavernous sinus has a convex outer border on the left as compared to concave on the right.

Case Discussion

Extension of a pituitary tumour into the cavernous sinus is often difficult to be certain on CT (or MRI for that matter).  The ICA is critical.  If tumour encases or at least 75% surrounds the distal ICA then cavernous sinus infiltration is likely as the vessel traverses the cavenous sinus.

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Case Information

rID: 42951
Case created: 16th Feb 2016
Last edited: 11th Dec 2016
Inclusion in quiz mode: Included

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