case_images: PMC10578389_01
case_images: (A) Contrast-enhanced coronal T1-weighted image centered on the sella demonstrates a hypo-enhancing lesion in the left aspect of the sella measuring 1.2 x 1.3 x 0.9 cm (AP, lateral, craniocaudal dimensions) with extension to the lateral intracarotid line (Knosp grade 2, not shown). Mild suprasellar extension without encroachment upon the optic chiasm or prechiasmatic optic nerve. (B) Contrast-enhanced coronal T1-weighed image centered on the sella obtained 3 years and 3 months later demonstrates mild interval decrease in the size of the hypo-enhancing lesion in the left sella, which now measures 1.2 x 1.0 x 0.7 cm (AP, lateral, craniocaudal dimensions), again with extension to the lateral intracarotid line (Knosp grade 2, not shown). Persistent mild suprasellar extension.
case_images: luad007f1.jpg
case_images: PMC10578389_01_luad007f1.jpg
case_images: luad007-F1
case_images: Pituitary MRI with and without contrast showed a left sellar mass compatible with a pituitary macroadenoma measuring 1.0 x 1.3 x 0.9 cm (Fig. 1).
case_images: Contrast-enhanced abdomen CT in the axial (A, B) and coronal (C) planes demonstrates a lobulated, heterogeneously enhancing mass arising from the tail of the pancreas (white arrows, 2A, 2C) measuring 5.9 x 5.1 x 6.1 cm (AP, lateral, craniocaudal dimensions). Mass obliterates the splenic vein (not shown). Necrotic peripancreatic and periportal lymph nodes are present, measuring up to 2.6 cm in maximal dimension (black arrowheads, 2B). Nodular thickening of the left adrenal gland (black arrow, 2A) that demonstrated washout consistent with a lipid-poor adenoma.
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case_images: PMC10578389_01_luad007f2.jpg
case_images: luad007-F2
case_images: The left adrenal nodule had radiological characteristics of a lipid-poor adenoma (washout 69.4%) (Fig. 2).