case_images: PMC6357293_01
case_images: Changes in plasma cortisol after dynamic endocrine tests.
case_images: 10.1177_1179551419825832-fig1.jpg
case_images: PMC6357293_01_10.1177_1179551419825832-fig1.jpg
case_images: fig1-1179551419825832
case_images: Table 2.Plasma cortisol increases after the DDAVP test and cortisol decreases after 8 mg of nocturnal dexamethasone suggested Cushing disease (Figure 1). A pituitary magnetic resonance image (MRI) was obtained revealing a large mass (36 x 46 x 46 mm) in the skull base centered in the sphenoid sinus with caudal extension in the nasopharynx and posterior extension in the clivus.
case_images: A contrast-enhanced magnetic resonance image of the brain showing a large mass in the skull base involving the sella and extending in the nasopharynx the clivus.
case_images: 10.1177_1179551419825832-fig2.jpg
case_images: PMC6357293_01_10.1177_1179551419825832-fig2.jpg
case_images: fig2-1179551419825832
case_images: The mass completely involved the sella (preventing pituitary gland identification) although without compromising the pituitary stalk and the optic chiasm (Figure 2). The mass was also identified with an Indium-111 octreotide scan confirming somatostatin receptor expression.
case_images: A magnetic resonance image of the brain 1 year after radiotherapy showing the stability of the tumor size.
case_images: 10.1177_1179551419825832-fig3.jpg
case_images: PMC6357293_01_10.1177_1179551419825832-fig3.jpg
case_images: fig3-1179551419825832
case_images: A new MRI revealed mass stability persisting in the last follow-up 1 year after radiotherapy (Figure 3).