Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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February 17, 2014
Pituitary Macroadenoma
- Pituitary adenoma is the most common sellar-based lesion. It can either be a microadenoma (< 1.0 cm in size) or macroadenoma (> 1.0 cm in size). Microadenomas typically produce endocrinologic symptoms or remain asymptomatic. Macroadenomas produce symptoms related to mass effect on adjacent structures or endocrinologic symptoms.
- Key Diagnostic Features: Sellar mass without separate identifiable pituitary gland. Location: intra- or combined intra/suprasellar. May extend into the parasellar (cavernous sinus) compartment. These lesions are typically isointense to the gray matter and demonstrate enhancement. Intralesional cyst formation is known. Giant adenomas are > 4.0 cm in diameter and may invade the skull base. A “figure-of-eight” or “snowman” appearance is well described in the literature when the seillar based mass extends into the suprasellar compartment.
- DDx: Craniopharyngioma, meningioma, metastases, chordoma
- Rx: Surgical resection
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