EURORAD ESR

Case 14810

Invasive atypical pituitary neoplasm with prolactin immunoreactivity

Author(s)
Magdalena Pucurull, MD.1, Donato Angel, MD, Figueroa Ramon E. MD, FACR. 2

(1) Hospital de clínicas; Avenida Italia, 1600 Montevideo, Uruguay;
(2) Augusta University, Augusta GA, USA
Email:maggiep126@hotmail.com
 
Patient
male, 46 year(s)
 
 
  • Figure 1
    Head CT
     

    Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles. Notice clivus erosion on Figure 1a.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CAD; Procedure: Education; Special Focus: Pathology;

    Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles. Notice tuberculum sella erosion on Figure 1c.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;

    Suprasellar mass with distortion of the ventricular system and brain parenchyma.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 2
    MRI T1, T2, Ti postgd. DWI. ADC.
     

    Large mixed solid and haemorrhagic central skull base mass arising from sellar fossa with large volume suprasellar extension.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    Large mixed solid and haemorrhagic central skull base mass arising from sellar fossa with large volume suprasellar extension. Notice haemorrhagic fluid levels within lesion peripheral cysts.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    Large mixed solid and haemorrhagic central skull base mass with diffuse Gadolinium enhancement of cyst capsules and solid tumour components.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    Large haemorrhagic central skull base mass susceptibility signal loss from haemosiderin/ haemorrhage byproducts.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    Large haemorrhagic central skull base mass with diffusion restriction behaviour in portions of the tumour mass.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 3
    MRI Sagittal T1 Pre and post-gd
     

    The mass invades through the skull base and clivus inferiorly and into the suprasellar cistern superiorly, with optic chiasm compression.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    The mass diffusely involves the sella turcica without visualisation of the infundibulum or the pituitary gland after gadolinium administration.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 4
    MRI Coronal T1 Pre and post-gd
     

    Notice left haemorrhagic polar cyst above the suprasellar tumour extension.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;

    There is intense enhancement of the mass from suprasellar space through sella and central skull base.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Education; Special Focus: Pathology;
     
     
Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles. Notice clivus erosion on Figure 1a.
 
Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles.
 
Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles. Notice tuberculum sella erosion on Figure 1c.
 
Expansile sellar mass with extra-axial compression of brain parenchyma and ventricles.
 
Suprasellar mass with distortion of the ventricular system and brain parenchyma.
 
Large mixed solid and haemorrhagic central skull base mass arising from sellar fossa with large volume suprasellar extension.
 
Large mixed solid and haemorrhagic central skull base mass arising from sellar fossa with large volume suprasellar extension. Notice haemorrhagic fluid levels within lesion peripheral cysts.
 
Large mixed solid and haemorrhagic central skull base mass with diffuse Gadolinium enhancement of cyst capsules and solid tumour components.
 
Large haemorrhagic central skull base mass susceptibility signal loss from haemosiderin/ haemorrhage byproducts.
 
Large haemorrhagic central skull base mass with diffusion restriction behaviour in portions of the tumour mass.
 
The mass invades through the skull base and clivus inferiorly and into the suprasellar cistern superiorly, with optic chiasm compression.
 
The mass diffusely involves the sella turcica without visualisation of the infundibulum or the pituitary gland after gadolinium administration.
 
Notice left haemorrhagic polar cyst above the suprasellar tumour extension.
 
There is intense enhancement of the mass from suprasellar space through sella and central skull base.
 
 
 
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