case_images: PMC11128223_01
case_images: Grayscale maps of Humphrey's Visual Field Tests conducted prior to surgery (A - Left, B - right), three months after surgery (C - Left, D - Right).
case_images: IMCRJ-17-527-g0001.jpg
case_images: PMC11128223_01_IMCRJ-17-527-g0001.jpg
case_images: f0001
case_images: She was discharged one week after surgery, and at 3 months of follow-up, she was initiated on adjuvant radiotherapy but was well and seizure free (while on Levetiracetam) without any visual deficits. (Figure 1C and D, Figure 3) She is being closely followed up by the endocrinology team headed by a senior consultant endocrinologist and has not shown to have clinical or biochemical indicators of pituitary dysfunction.
case_images: (A) Sagittal (B) Axial (C) Coronal; Neuro-Navigation Guided Magnetic Resonance Images depicting the large pituitary tumour with suprasellar extension through the third ventricle into both lateral ventricles causing significant mass effect and impending hydrocephalus (volume of 36.081 cm3). T: Tumour; CB: Cerebellum; BS: Brainstem; 1: Superior sagittal sinus; 2: Internal cerebral vein; 3: Vein of Galen; 4: Basilar artery; 5: Internal carotid arteries; 6: Left medial temporal lobe; 7: Lateral ventricles; 8: Floor of the sella turcica largely obliterated by the tumour extending into the sphenoid sinus; 9: Left cavernous sinus.
case_images: IMCRJ-17-527-g0002.jpg
case_images: PMC11128223_01_IMCRJ-17-527-g0002.jpg
case_images: f0002
case_images: Magnetic resonance imaging was subsequently used to detect a large pituitary tumour measuring 6.0 cm (craniocaudal) x 3.8 cm (transverse) x 4.0 cm (anteroposterior) with suprasellar extension through the third ventricle into both lateral ventricles, causing significant mass effects and impending hydrocephalus (Wilson-Hardy classification: IVC, Knosp classification: 0; Goel classification: IV) (Figure 2).
case_images: (A) Axial; (B) Coronal; T2 Magnetic Resonance Images depicting the residual tumour (<60%) at 3 months of follow-up from the subtotal resection via the endonasal transsphenoidal approach prior to initiation of radiotherapy. *: Residual tumour in the lateral ventricles; 1: Lateral ventricles; 2: Third ventricle; 3: Fat graft placed during the transsphenoidal approach into the tumour.
case_images: IMCRJ-17-527-g0003.jpg
case_images: PMC11128223_01_IMCRJ-17-527-g0003.jpg
case_images: f0003
case_images: She was discharged one week after surgery, and at 3 months of follow-up, she was initiated on adjuvant radiotherapy but was well and seizure free (while on Levetiracetam) without any visual deficits. (Figure 1C and D, Figure 3) She is being closely followed up by the endocrinology team headed by a senior consultant endocrinologist and has not shown to have clinical or biochemical indicators of pituitary dysfunction.