MRI
Coronal T1
Coronal T2
Coronal T1 C+
What is the diagnosis?
Appearances are almost certainly those of a pituitary macroadenoma.
What is the usual operative approach to these lesions?
Transsphenoidal microsurgical or endoscopic surgery is usual.
The pituitary fossa is enlarged by a well circumscribed enhancing ovoid mass measuring 16 x 25 x 22 mm. The diaphragma sella is elevated and widely spread (diaphragmatic hiatus is approximately 2 cm wide). The optic chiasm is markedly elevated and thinned by the suprasellar component of the mass, and the A1/Acom/A2 complex is in close apposition to the superior surface of the mass, also elevated. There is no evidence of cavernous sinus involvement, and flow voids in the internal carotid arteries are unremarkable in appearance and location.