case_images: PMC11037097_01
case_images: T1-weighted sagittal (a) and coronal (b) and T2-weighted coronal (c). Magnetic resonance imaging of the pituitary gland with intravenous contrast (pretreatment). The sella turcica is enlarged and bulging into the sphenoid sinus (S). There is a large sellar and suprasellar solid (red star) and cystic (yellow star) mass lesion. The solid component shows heterogeneous contrast enhancement. The cystic non-enhancing part extends into the left cavernous sinus (red arrow), and the solid suprasellar component encases the supraclinoid left ICA (blue arrow).
case_images: qmj-2024-01-017-g001.jpg
case_images: PMC11037097_01_qmj-2024-01-017-g001.jpg
case_images: fig1
case_images: The patient underwent a pituitary MRI at our institution (Figure 1), which showed an irregular, mainly suprasellar T1 isointense, T2 dark, and homogenously enhancing pituitary macroadenoma (maximum axial diameter of about 29 mm).
case_images: Prolactin levels over the course of the patient's management.
case_images: qmj-2024-01-017-g002.jpg
case_images: PMC11037097_01_qmj-2024-01-017-g002.jpg
case_images: fig2
case_images: Prolactin levels normalized (Figure 2); however, IGF-1 did not improve (Figure 3).
case_images: Changes in insulin-like growth factor 1 (IGF-1) levels over the course of the patient's management.
case_images: qmj-2024-01-017-g003.jpg
case_images: PMC11037097_01_qmj-2024-01-017-g003.jpg
case_images: fig3
case_images: Prolactin levels normalized (Figure 2); however, IGF-1 did not improve (Figure 3).
case_images: T1-weighted sagittal (a) and coronal (b), and T2-weighted coronal (c). Magnetic resonance imaging of the pituitary gland with intravenous contrast (post-treatment). There is no significant change in the size of the pituitary macroadenoma compared to the pretreatment pituitary MRI.
case_images: qmj-2024-01-017-g004.jpg
case_images: PMC11037097_01_qmj-2024-01-017-g004.jpg
case_images: fig4
case_images: Pituitary MRI after 6 months of pasireotide treatment showed no changes (Figure 4).