Presentation
Secondary amenorrhea and elevated prolactin (over 1200)
Patient Data
On the right side of the pituitary gland, inferiorly, abutting the floor of the fossa, is a 3 x 4 x 5 mm region of hypo enhancement, best seen on dynamic contrast enhanced sequences, consistent with a microadenoma. The pituitary is generally plumper, with an upwardly convex border, which is however common in this age group. No compression of the optic chiasm or optic nerves.
The remainder of the imaged brain (please note this study has been targeted to the pituitary, and as such the whole brain has not been imaged) appears unremarkable.
Case Discussion
When there is a known hormone producing lesion, a small microadenoma can be diagnosed with confidence. This is clearly abnormal and no equivocation is needed.
The patient is undergoing medical therapy.
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