Pituitary microadenoma

History A 33-year old woman presents with irregular menses and galactorrhea. Exam Physical exam was normal Pregnancy test (bHCG) negative Serum Prolactin was elevated (>1005 ng/mL) Findings High-resolution contrast-enhanced MRI depicts a small hypointense lesion, measuring 0,2 x 0,2 x 0,4 cm, against a hyperintense background of normally enhancing pituitary gland. Differential Diagnosis Differential diagnosis includes: Pituitary microadenoma, Rathke cleft cyst, pars intermedia cyst, craniopharyngioma, pituitary hyperplasia. Case Diagnosis Pituitary microadenoma Diagnosis By MR Imaging findings and history Treatment & Follow Up The patient is receiving bromocriptine and is responding to therapy. Discussion This was a case of a typical pituitary microadenoma more slowing enhancing than normal pituitary gland, although dynamic contrast-enhanced MR Imaging was not used. Despite the signal intensity abnormalities it is also useful to look for morphologic abnormalities such as, localized bulging and depressions of the sellar floor, thinning or blistering of the sellar walls and deviation of the pituitary infundibulum. Video - http://www.youtube.com/watch?v=zvl84zH8JEA



Excellent case presentation