Presentation
Blurred vision.
Patient Data
A large ovoid mass lesion is seen filling and expanding the sellar cavity with suprasellar extension. It is a solid lesion with multiple internal cystic changes and a clear fluid signal. It shows an isointense signal on T1 and T2 with homogeneous post-contrast enhancement. It shows parasellar extensions abutting internal carotid arteries and cavernous sinuses, more on the right side. It is indenting and stretching the optic chiasm and indenting the floor of the 3rd ventricle. Posteriorly, it indents the prepontine cistern.
Case Discussion
This case demonstrates a sizeable pituitary macroadenoma with cystic changes. Cystic changes may result from necrosis or haemorrhage. The larger the macroadenoma, the higher the risk of undergoing cystic degeneration.
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