Presentation
Visual field defect.
Patient Data
A mass centered in the pituitary fossa has enlarged and remodeled the pituitary fossa.
Conclusion:
This most likely represents a pituitary macroadenoma. MRI is required for further assessment.
The pituitary fossa is enlarged by a mass that enhances and has a conspicuously low T2 signal. The right cavernous sinus is invaded. The right ICA is not narrowed. The optic chiasm is elevated.
Conclusion:
Although enlargement of the pituitary fossa and growth pattern is typical for a pituitary macroadenoma, the low T2 signal is unusual. Other possibilities include solitary fibrous tumors of the dura and infiltration with fibrotic tissue (e.g. IgG4 disease or Erheim Chester disease).
Case Discussion
The patient went on to have a transsphenoidal resection and the lesion was found to be a solitary fibrous tumor and STAT6 was identified on immunohistochemistry.
He has been followed up for over 10 years and has had a sizable recurrence resected.
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