MRI - MRI pituitary
Sagittal T1
T1 C+
Coronal T1
T1 C+
Coronal T2
T1 C+
T1 C+
T1 C+
Given the patient's presentation, what are the possible histologies?
Prolactinoma or potentially null-cell adenoma with stalk effect, resulting in elevated prolactin. Mixed histology is of course a possibility also and pituitary function tests are necessary.
MRI of the pitutary including dynamic contrast enhanced sequences demonstrates a 11 x 12 x 9 mm mass in the left pituitary gland. There is remodelling of the sellar floor, which slopes to the left. There is displacement of the infundibulum and normal pituitary tissue to the right. There is slight tilting of the chiasm, but without chiasmal contact.
While the mass abuts the left cavernous carotid, there are no specific signs for cavernous sinus invasion.