case_images: PMC10757430_01
case_images: Axial T2-weighted image (a) and sagittal T2 (b), T1 FLAIR (Fluid-attenuated inversion recovery) (c) and T1 Fat-Sat GD+ (d) images with a focus on the sellar and sphenoid sinus (SS) regions. Visualization of a space-occupying mass in the right SS (arrow), the sella turcica is empty, only filled with cerebrospinal fluid (White arrowhead) ((a)-(c)). The injected sequence (d) shows a very mild enhancement of the mass, and does not visualize any sella turcica floor defect (Black arrowhead), which was confirmed during the surgical procedure.
case_images: 10.1177_2050313X231223465-fig1.jpg
case_images: PMC10757430_01_10.1177_2050313X231223465-fig1.jpg
case_images: fig1-2050313X231223465
case_images: T1 and a slight hypersignal on T2-weighted sequence (compared to white matter) (Figure 1). The mass did not invade the walls of the SS nor the sella tucica floor; however, it was causing obstruction of the SS ostium with mucus retention (Figure 2).
case_images: Coronal T2-weigted image showing the pituitary adenoma (arrow) obstructing the sphenoid sinus ostium obstruction with mucous retention around the mass (arrow heads).
case_images: 10.1177_2050313X231223465-fig2.jpg
case_images: PMC10757430_01_10.1177_2050313X231223465-fig2.jpg
case_images: fig2-2050313X231223465
case_images: T1 and a slight hypersignal on T2-weighted sequence (compared to white matter) (Figure 1). The mass did not invade the walls of the SS nor the sella tucica floor; however, it was causing obstruction of the SS ostium with mucus retention (Figure 2).
case_images: Coronal T2-weigted (a) and T1 Fat-Sat GD+ (b) images showing the pituitary stalk diving in the CSF filled sella, realizing the "infundibulum sign."
case_images: 10.1177_2050313X231223465-fig3.jpg
case_images: PMC10757430_01_10.1177_2050313X231223465-fig3.jpg
case_images: fig3-2050313X231223465
case_images: This observation aligns with the classical characteristics of macroadenomas, where the pituitary parenchyma is excessively stretched and thinned to the point of being imperceptible. (Figures 3 and 4).
case_images: Coronal Dynamic contrast-enhanced (DCE) sequences passing through the sella turcica (Column A) revealed the normal enhancement of the pituitary stalk and the absence of normal pituitary parenchyma inside the sella turcica. Additionally, slices passing through the ectopic adenoma (Column B) displayed a mild and persistent enhancement of the mass, without the presence of normal pituitary parenchyma around it.
case_images: 10.1177_2050313X231223465-fig4.jpg
case_images: PMC10757430_01_10.1177_2050313X231223465-fig4.jpg
case_images: fig4-2050313X231223465
case_images: This observation aligns with the classical characteristics of macroadenomas, where the pituitary parenchyma is excessively stretched and thinned to the point of being imperceptible. (Figures 3 and 4).
case_images: Image showing the histological appearance of specimens taken from this patient. It reveals the presence of diffusely growing adenoma cells with eosinophilic or chromophobe cytoplasm.
case_images: 10.1177_2050313X231223465-fig5.jpg
case_images: PMC10757430_01_10.1177_2050313X231223465-fig5.jpg
case_images: fig5-2050313X231223465
case_images: The histopathological and immunohistochemical examination were in favor of a prolactinoma (Figure 5).