PMC7784236_01
Humphrey visual field test results for patient's left (A) and right (B) eyes, confirming a dense bitemporal visual loss.
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Physical examination was unremarkable except that visual field examination confirmed bitemporal hemianopia (Figure 1).
Magnetic resonance imaging of the pituitary showing lobulated heterogenous sellar mass with suprasellar extension and compression of optic chiasm, sagittal view in A and coronal view in B.
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A subsequent cranial magnetic resonance imaging (MRI) scan displayed a lobulated heterogeneous enhancing mass approximately 1.7 x 1.9 x 2.0 cm arising from the sella turcica with suprasellar extension and compression of the optic chiasma (Figure 2).
Pathological fracture of the left proximal humerus.
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Left shoulder x-ray showed pathological fracture of the left proximal humerus (Figure 3) and chest radiography (Figure 4) showed suspicious left lung nodule.
Suspicious left lung nodule.
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Left shoulder x-ray showed pathological fracture of the left proximal humerus (Figure 3) and chest radiography (Figure 4) showed suspicious left lung nodule. CT of the thorax, abdomen and pelvis revealed a mass (3.3 x 4.9 x 3.6 cm) at the posterior basal segment of left lower lobe (Figure 4) with multiple lung nodules of varying size noted bilaterally, enlarged mediastinal and hilar lymph nodes, and lytic lesion at proximal humerus and L5 vertebral body.