Presentation
1-week history of difficulty walking and altered mentation. The patient also reported problems with the loss of balance, vision, disequilibrium, and lightheadedness.
Patient Data
There is a large sella, suprasellar mass with expansion of the sella. It measures 4.5 x 2.5 x 2.8 cm in size. Heterogenous on T2-weighted imaging.
Slight increase in density seen on FLAIR sequence.
Isointense to gray matter seen on T1-weighted imaging.
There is both a homogeneous and lobulated appearance.
Large enough with compression of the region of the foramen of Monroe bilaterally.
Slight prominence of the lateral ventricles. Periventricular white matter changes.
IMPRESSION
Enlarged mass arising from the sella with significant suprasellar extension into the anterior lobulation. Measures 4.5 x 2.5 x 2.8 cm in size. Expansion of the sella, displacement of the optic chiasm and significant extension into the suprasellar region with some degree of compression of the foramen bilaterally with slight prominent lateral ventricles.
Case Discussion
This represents a case of a pituitary macroadenoma. Based on the clinical presentation of the patient, a computed tomography scan of the head was performed, revealing a suprasellar mass. MRI confirmed a pituitary mass with suprasellar and lobular extension. A transsphenoidal resection of the mass was chosen as treatment for this patient.
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