Zygomaticomaxillary complex fracture, orbital blow-out fracture and a pituitary macroadenoma

Case contributed by Liter Nguri
Diagnosis probable

Presentation

Road traffic accident

Patient Data

Age: 50 years
Gender: Male
Sagittal
non-contrast
This study is a stack
Axial
non-contrast
This study is a stack
Axial
non-contrast
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Info

A relatively well-circumscribed midline homogeneously hyperdense soft tissue density lesion of ~44 to 54HU is noted occupying sellar and suprasellar region showing a mass effect on foramen of Monro with resultant moderate dilatation of bilateral lateral ventricles (right atrium ~1.8 cm, left atrium~2 cm). The lesion measures​ about (4 x 3.2 x 3 cm), in craniocaudal, transverse, anteroposterior dimensions respectively.

Comminuted fracture of the right zygomatic arch is noted with minimal displacement.

Fracture at posterolateral wall and floor of right orbit with minimal displacement is noted.

Mildly comminuted fracture with depression is noted at the medial wall of right orbit showing mild herniation of orbital fat.

Minimal right pneumoorbit is noted.

Undisplaced fracture lines are seen in the right maxillary sinus.

Fracture at the right lateral pterygoid plate is noted.

Soft tissue contusion with hematoma formation seen at the right frontal, periorbital and maxillary region.

Case Discussion

This case demonstrates the typical CT features of a pituitary macroadenoma, right zygomaticomaxillary complex fracture in combination with a blow-out type fracture of the right medial orbital wall.

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