Pituitary microadenoma - hemorrhagic

Case contributed by Varun Babu
Diagnosis probable

Presentation

Increasing weight, decreased vision came for an MRI sella to rule out sellar mass lesion.

Patient Data

Age: 16 years
Gender: Female

MRI sella

mri
  • mildly bulky appearing pituitary gland with maximal craniocaudal height of 9.5mm. 
  • shift of normal thickness pituitary stalk to right. 
  • a well defined T1 hyperintense lesion is seen confined to the left half of anterior pituitary. 
  • normal posterior pituitary bright spot. 
  • optic nerves, tract and chiasm are not involved. 
  • screening neuroparenchyma is unremarkable. 

Case Discussion

Hemorrhagic changes may be identified in pituitary adenomas which makes them appear hyperintense on T1 non contrast images itself. This obscures the dynamic contrast enhanced study that ensues in providing more clinical information. Pituitary apoplexy should also be considered. 

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