Presentation
Increasing frequency of drooping of left face with generalized shaking of her body with loss of consciousness.
Patient Data
There is a large sellar/suprasellar lesion demonstrating intrinsic T1 shortening involving the pituitary gland and enlarging the sella. Laterally, this mildly extends into the right cavernous sinus. Superiorly, the suprasellar cistern is effaced with mass effect upon the optic chiasm and proximal prechiasmatic segments of the optic nerves. On the axial T2 sequence, there is suggestion of some susceptibility effects with a fluid level, which may be related to internal hemorrhage.
Case Discussion
This is a case of a pituitary macroadenoma with apoplexy. The patient underwent surgical excision with a conjoined effort by neurosurgery and otolaryngology. Intraoperative frozen pathology displayed findings of chronic hematoma/hemorrhage formation within the pituitary mass. Final histopathology pathology confirmed a pituitary adenoma. Stains were only positive for CAM-5.2 (with no fibrous bodies), with expanded but disrupted reticulin framework. The mass had low Ki67 (<2%) and P53 (<5%) labeling.
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