Pituitary microadenoma (haemorrhagic)

Case contributed by Dr Varun Babu ◉

Diagnosis almost certain

Presentation

Increasing weight, decreased vision came for an MRI sella to rule out sellar mass lesion

Patient Data

Age: 16 years old

Gender: Female

From the case: Pituitary microadenoma (haemorrhagic)

MRI

MRI sella

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Sagittal T1

mildly bulky appearing pituitary gland with maximal craniocaudal height of 9.5mm.
shift of normal thickness pituitary stalk to right.
a well defined T1 hyperintense lesion is seen confined to the left half of anterior pituitary.
normal posterior pituitary bright spot.
optic nerves, tract and chiasm are not involved.
screening neuroparenchyma is unremarkable.

Case Discussion

Haemorrhagic changes may be identified in pituitary adenomas which makes them appear hyperintense on T1 non contrast images itself. This obscures the dynamic contrast enhanced study that ensues in providing more clinical information. Pituitary apoplexy should also be considered.