case_images: PMC3485864_01
case_images: Clinical signs and MRI brain findings of the child. (a) The coarse facial features and myxedematous appearance. (b) Dark and thick hair on the back of the obese child. (c) MRI brain sagittal scan showing pituitary enlargement and homogeneous intrasellar mass with suprasellar extension. (d) MRI brain coronal scan showing the "snowman sign," pituitary enlargement upward protruding into the suprasellar cistern, with no significant compression on optic chiasm and uniform T2 signal.
case_images: CRIM.PEDIATRICS2012-352751.001.jpg
case_images: PMC3485864_01_CRIM.PEDIATRICS2012-352751.001.jpg
case_images: fig1
case_images: BMI 33.1 (>95th percentile). He had coarse facial features with myxedematous appearance (Figure 1(a)), palpable but not enlarged thyroid gland, dark and thick hair on the back (Figure 1(b)), absent axillary and pubic hair, cold extremities, and no dysmorphic features. Bilateral testicular volume was 14 ml in size as measured by Prader orchidometer and stretched penile length was 8 cm. MRI brain showed diffuse enlargement of the pituitary gland, with no limitation in the lesion size, uniform signal lesions of the pituitary gland, and consistent strength is seen with no apparent mass effect (Figures 1(c) and 1(d)).