Aggressive giant pituitary adenoma presenting as a nasopharyngeal mass: magnetic resonance imaging and pathologic findings.
We report a giant pituitary adenoma with aggressive histologic features that prominently invaded the nasopharynx. Magnetic resonance imaging (MRI) demonstrated a large heterogeneous nodular mass that was hypointense to isointense on T1-weighted images and mixed hypointense, isointense, and hyperintense on T2-weighted images. The mass measured 7.5 x 5 x 7 cm, extending from the nasopharynx posteriorly through the clivus, and superiorly through the paranasal sinuses, and sellar-suprasellar region. After contrast administration, heterogeneous nodular enhancement was noted. A nasopharyngeal neoplasm extending into the sella was suspected because voice change and nasal speech long preceded the patient's visual symptoms. A biopsy disclosed an aggressive, infiltrating, hemorrhagic tumor, which was diagnosed as a non-secreting pituitary macroadenoma. This report indicates that pituitary adenomas may grow invasively to tremendously large sizes resulting in their initial presentation as nasopharyngeal masses.
Ravichandran
T P
TP
Department of Neurology, Dent Neurological Institute, Buffalo, NY, USA.
Bakshi
R
R
Heffner
R R
RR
Gibbons
K J
KJ
Bates
V E
VE
Durante
D J
DJ
Kinkel
W R
WR
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011388:Prolactin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone / Q000097:blood
D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin