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case_images: The progression of the pituitary lesion in MRI: (A) a suspicious low signal in the right-wing of the pituitary (January 15, 2019), (B) enlargement of the pituitary lesion involving right cavernous sinus (June 28, 2019), (C) involvement of the right cavernous sinus and internal carotid artery (September 24, 2019), (D) a possible macroadenoma, Knosp IV (October 17, 2019).
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case_images: PRL), IGF-1, thyroid (TSH, FT3, FT4), immunology (IgG4, ANCA, sACE, ESR) and tumor markers tests (CEA, AFP, betahCG), which were all within the normal range. The MRI indicated a possible sellar macroadenoma (12.7 x 6.7 x 11.1 mm) with Knosp IV; the progression of the sellar lesion is shown in  Figure 2 . Physical examination revealed truncal obesity and diabetes mellitus due to glucocorticoid treatment.
case_images: The lesion in the sellar region involving bilateral cavernous sinus as shown in MRI. (A) before chemotherapy; (B) after two courses of chemotherapy (R2-MTX).
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case_images: MRI confirmed a significant reduction in the size of the sellar mass ( Figure 3 ).
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