Presentation
Hypogonadism and low libido.
Patient Data
A large heterogeneous solid mass has expanded the pituitary fossa and extends into the suprasellar cistern, touching the optic chiasm without displacement. The mass enhances. On T2, the diaphragma sella is elevated.
Remnant pituitary tissue is located at the posterior superior aspect on the right side. No cavernous sinus extension.
Case Discussion
The patient went on to have a transsphenoidal resection.
Histology
Paraffin sections show fragments of a moderately hypercellular adenoma. Tumor cells have uniform round and oval hyperchromatic nuclei and a moderate amount of pale cytoplasm and are arranged in trabeculae and diffuse sheets in a vascular stroma. No mitotic figures or areas of necrosis are identified, and no normal anterior pituitary tissue is included.
No immunostaining for growth hormone, prolactin, ACTH, FSH or TSH is seen in tumor cells. Scattered groups of tumor cells show moderate staining for LH.
Final diagnosis:
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