A young male came for evaluation of visual field deficit. Pt was clinically stable.
This MRI study of Brain shows:
MRI sagittal T1 and T2 w images show a sellar supra sellar oblonged cystic mass.
Cyst is slightly hyper intense than Csf on T1 and iso intense on FLAIR due to lack of signal suppression of fluid implies to thick viscous content of cyst. Thick profusely enhancing wall around cyst on Post contrast T1w images.
No solid component or multilocularity of cyst.
T1 bright normal posterior lobe of pituitary seen stretched along posterior wall of cyst on sagittal non contrast T1w images. Pituitary gland not seen separately in hypophyseal fossa. Pituitary stalk is seen ending at the top of cyst. Supra sellar anatomy distorted. Optic nerve and chiasma compressed.
Cyst is slightly hyper intense than Csf on T1 and iso intense on FLAIR due to lack of signal suppression of fluid implies to thick viscous content of cyst. Thick profusely enhancing wall around cyst on Post contrast T1w images.
No solid component or multilocularity of cyst.
T1 bright normal posterior lobe of pituitary seen stretched along posterior wall of cyst on sagittal non contrast T1w images. Pituitary gland not seen separately in hypophyseal fossa. Pituitary stalk is seen ending at the top of cyst. Supra sellar anatomy distorted. Optic nerve and chiasma compressed.
Imgingwise DDs: Cystic pituitary adenoma more likely than Rathke’s cleft cyst (Thick profusely enhancing wall around cyst goes against Rathke’s cleft cyst).
Transnasal Transphenoid approach attempted.
Histopathology report : Pituitary Adenoma with Necrosis.
Transnasal Transphenoid approach attempted.
Histopathology report : Pituitary Adenoma with Necrosis.
Rare?
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