Pituitary macroadenoma

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  • 60-year-old patient with a large heterogeneously enhancing lesion within an expanded pituitary fossa. The optic chiasm is elevated and compressed.

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  • 25-year-old patient presented with a seizure.
  • MRI showed a large, enhancing (not shown) lesion centred in the pituitary fossa but with extensive erosion of the skull base.
  • A haemtoma formed in the right lateral aspect of the lesion, the mass effect of which presumably provoked the seizure.
  • Serum prolactin was >800,000. Prolactin levels and the size of the lesion significantly reduced after starting cabergoline.
  • 60-year-old patient presented with facial changes typical of acromegaly.
  • MRI showed a 1.2 cm T2-hypointense lesion in the anterior aspect of the pituitary gland. The lesion was subtly hypoenhancing.

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  • A 25-year-old patient presented with headache and visual disturbance.
  • MRI showed a massive skull base lesion centred on the pitutary fossa with involvement of the cavernous sinuses and extension along the clivus.
  • After 1 year on cabergoline, the prolactinoma shrunk to a fraction of its original size.