Post partum enlargement of pituitary

Case contributed by A.Prof Frank Gaillard

Presentation

Incidental finding on MRI brain for headache, in a 2 week post-partum woman.

Patient Data

Age: 35
Gender: Female

The pituitary gland is enlarged and measures 13 x 16 x 13 mm. The lesion contacts the optic chiasm which is slightly distorted however not compressed. The infundibulum is deviated towards the left. No evidence of cavernous invasion. No focal mass evident. Normal dynamic enhancement (not shown). 

MRI

MRI pituitary - 3 months later

The pituitary gland has regained normal dimensions with no features on either delayed contrast enhanced sequences or dynamic contrast enhanced (not shown) sequences to suggest an underlying tumour. As such the previous appearance is deemed to be physiological enlargement secondary to gestation.

Case Discussion

The enlargement of the pituitary gland in the setting of pregnancy is remarkable, and care must be taken not to diagnose a macroadenoma or lymphocytic hypophysitis. A follow up scan will show gradual reduction of the pituitary to 'normal' size. 

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Case information

rID: 30620
Case created: 22nd Aug 2014
Last edited: 28th Oct 2015
Inclusion in quiz mode: Included

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