case_images: PMC11150949_01
case_images: Brain CT scan without contrast, axial view. Intrasellar mass with extension to suprasellar cistern and adjacent bone erosion.
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case_images: F1
case_images: A brain computed tomography (CT) scan revealed a homogeneous iso-dense extra-axial intrasellar round mass extending to the suprasellar region, predominantly on the left side, with bony erosion and osteolysis around the sellar region (Figure 1).
case_images: (A) Coronal view of T1-weighed brain MRI without Gadolinium injection. Well defined sellar mass with extension to suprasellar cistern. (B) Axial view of T2-weighed brain MRI without Gadolinium injection. Well defined sellar mass with extension to suprasellar cistern and adherent to both carotid arteries.
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case_images: F2
case_images: T1-weighted images and hypersignal on T2-weighted images, originating from the pituitary gland within the sella turcica. The mass avidly enhanced following Gadolinium injection and was adherent to both carotid arteries without vascular compression or invasion, extending to the suprasellar cistern and compressing the optic chiasm (Figures 2, 3).
case_images: (A) Coronal T1-weighted brain MRI with Gadolinium contrast injection depicting a distinctive avidly enhanced sellar mass extending to the suprasellar cistern and adhering to both carotid arteries. (B) Sagittal T1-weighted brain MRI with Gadolinium contrast injection reveals a well-defined, prominently enhanced sellar mass extending into the suprasellar cistern and adherence to both carotid arteries.
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case_images: F3
case_images: T1-weighted images and hypersignal on T2-weighted images, originating from the pituitary gland within the sella turcica. The mass avidly enhanced following Gadolinium injection and was adherent to both carotid arteries without vascular compression or invasion, extending to the suprasellar cistern and compressing the optic chiasm (Figures 2, 3).
case_images: A post-operative brain CT scan, conducted without contrast injection, depicted the resection of the sellar and suprasellar mass, along with the implantation of abdominal subcutaneous fat tissue.
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case_images: F4
case_images: There was a remarkable improvement in visual acuity during the early postoperative period (right eye: 5 meters counting fingers, left eye: 5 meters counting fingers), and a postoperative brain CT scan showed no residual mass (Figure 4).
case_images: (A) Histopathologic examination revealed a hypervascular neoplasm of branching vessels surrounded by bland-looking pericytes with oval to spindle nuclei without evidence of anaplasia, necrosis, or hemorrhage. (B) IHC stain positive for STAT6 in tumoral cells. (C) IHC stain demonstrates that Ki67 is low. (D) IHC stain for CD34 highlights vascular proliferation.
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case_images: F5
case_images: Immunohistochemistry staining was positive for STAT 6 in tumoral cells, while Ki67 was low, and CD-34 highlighted vascular proliferation:all consistent with HPC [World Health Organization (WHO) grade II] (Figure 5).
case_images: Post-operative brain MRI revealed no evidence of residual mass. Axial (A), coronal (B), axial with Gadolinium injection (C), sagittal with Gadolinium injection (E).
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case_images: F6
case_images: Both supra and infratentorial structures appeared grossly normal (Figures 6, 7).
case_images: Post op MRI on month 2 demonstrates gross total resection (GTR) of the sellar mass with suprasellar extension. Coronal view of T2 weighed (A), coronal view of T1 weighted following Gadolinium injection (B), axial view of T2 weighed (C), sagittal view of T2 weighted (D), sagittal view of T1 weighted Gadolinium injection (E), axial view of T1 weighted following Gadolinium injection (F).
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case_images: F7
case_images: Both supra and infratentorial structures appeared grossly normal (Figures 6, 7).