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Pituitary Macroadenoma - Case 3

A 47 year-old woman developed progressive headaches and difficulty with her vision. Neurological examination revealed a bitemporal hemianopsia.

Show the Tumor         Note the Displacement of the Optic Chiasm          Show the Gadolinium Enhancement

Pituitary Macroadenoma. (Left) T1-weighted sagittal MRI; (Right) T1-weighted with gadolinium sagittal MRI. Note the large enhancing mass in the region of the sella that is growing up into and displacing the optic chiasm and hypothalamus. The chiasm is draped and thinned over the mass. Surgical resection demonstrated a large pituitary adenoma.

By definition, pituitary macroadenomas are benign tumors of the pituitary gland that are greater than 10 mm in diameter. Similar to microadenomas, macroadenomas may come to medical attention due to signs and symptoms of endocrine dysfunction from excessive hormonal production. However, in contrast to microadenomas, macroadenomas may result in reduced hormone production of some or all of the pituitary hormones (panhypopituitarism) as the tumor grows and compresses the normal pituitary tissue. Macroadenomas may also result in focal neurological signs and symptoms due to mass effect as the tumor grows outside of the sella and compresses the optic chiasm and hypothalamus above. Lesions of the optic chiasm classically result in a bitemporal hemianopsia.


Revised 11/27/06.
Copyrighted 2006. David C Preston