Pituitary Adenoma

Adenomas Pituitary Radiology
Fig. 11.32a Sagittal MRI after contrast administration displays an intensely and homogeneously enhancing tumor that has expanded the sella and presses against the floor of the third ventricle. This is a macroadenoma of the pituitary gland. b The

coronal MR images document invasion of the cavernous sinus by the macroadenoma and a tumor sleeve extending around the carotid artery (arrow).

I Craniopharyngioma

I Craniopharyngioma

Third Ventricle Adenoma
Fig. 11.33 Sagittal MRI after contrast administration shows a tumor that accumulates contrast intensely in its periphery while its center appears to be cystic. The tumor has invaded the third ventricle. This is a craniopharyngioma.

chordomas of the clivus (Fig. 11.34b) or epidermoids (Fig. 11.34c) can also lead to compressive symptoms in the perisellar area.

Giant aneurysm: A giant aneurysm can originate anywhere in the circle of Willis and extend cranially, occasionally causing a compression of sellar and/or perisellar components (Fig. 11.35).

"Empty sella": The term "empty sella" designates a CSF-filled herniation of the meninges into the sella (Fig. 11.36) that can compress, for example, the pituitary gland. A similar situation (and image appearance) may of course develop after sellar surgery.

• Diagnosis: Paul puts two and two together. Mrs. Nuremberg is young and denies any endocrine symptoms. The lesion is primarily cystic and sits in the right location: this should be a craniopharyngioma. Paul is right. The visual field defect is associated with this tumor and its particular location characteristically is a bitemporal hemianopia. In

0 0

Post a comment