case_images: PMC9610038_01
case_images: (a) A high-density mass was seen on sagittal computed tomography in 2017 (white arrow). (b) T1-weighted sagittal image with iso-intensity showing the tumor located at the tuberculum sellae. (c) When the suprasellar tumor was initially found, the patient's visual field test on the right eye showed upper temporal quadrantanopsia.
case_images: SNI-13-407-g001.jpg
case_images: PMC9610038_01_SNI-13-407-g001.jpg
case_images: F1
case_images: A tumor of the tuberculum sellae was observed on whole-body computed tomography in 2017 [CT; Figure 1a], but it was not recognized. Magnetic resonance imaging (MRI) revealed a tumor (25 x 18 x 19 mm) in the tuberculum sellae [Figure 1b]. Humphrey perimetry revealed upper temporal quadrantanopsia [Figure 1c], but his visual acuity was intact (20/20). His serum prostate-specific antigen (PSA) was within the normal range at 3.900 ng/mL and his pituitary hormone level was also normal.
case_images: (a) Two months later, his visual acuity and field were aggravated. (b) Gadolinium T1-weighted image showing tumor growth with homogeneous enhancement two months later. Dural enhancement can also be seen. (c) Fast imaging with steady-state acquisition revealed that the right optic nerve (white arrow) was compressed by the tumor.
case_images: SNI-13-407-g002.jpg
case_images: PMC9610038_01_SNI-13-407-g002.jpg
case_images: F2
case_images: Humphrey perimetry revealed progressive visual field disturbance [Figure 2a]. MRI showed tumor growth (27 x 24 x 25 mm) with homogeneous and dural enhancement [Figure 2b]. Fast imaging with steady-state acquisition revealed that the right optic nerve was compressed by the tumor [Figure 2c] and malignant meningioma was suspected.
case_images: (a) Atypical epithelioid cells with vacuole proliferated in a sheeting pattern and focal gland-like formation can be seen (hematoxylin-eosin stain). (b and c) Immunohistochemically, the gland-like region was positive for prostate-specific antigen, and the nuclei of the tumor cells were diffusely positive for androgen receptor.
case_images: SNI-13-407-g003.jpg
case_images: PMC9610038_01_SNI-13-407-g003.jpg
case_images: F3
case_images: The gland-like formation was immunopositive for PSA and androgen receptor [Figures 3a-c].
case_images: (a) The tumor disappeared after radiation therapy following transsphenoidal surgery. (b) The visual field disorder improved with the disappearance of the tumor.
case_images: SNI-13-407-g004.jpg
case_images: PMC9610038_01_SNI-13-407-g004.jpg
case_images: F4
case_images: The tumor disappeared on MRI [Figure 4a] and his visual impairment improved [Figure 4b].