PMC5949168_01
Coronal MRI T1 sequence with gadolinium. Intra- and suprasellar tumor with extension to the floor of third ventricle, after first surgery.
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The patient underwent transsphenoidal resection in August 2013 (Figure 1).
Coronal and sagittal MRI T1 sequence with gadolinium. Intra- and suprasellar tumor with tumor growth related to previous study.
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In March 2016, a new MRI with a focus on the sellar region was performed, finding tumor remnant growth (Figures 2(a) and 2(b)).
Sagittal and coronal MRI T1 sequences with gadolinium. Residual tumoral tissue only located intrasellar and right parasellar after second surgery.
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After the annual biochemical monitoring of the gonadal hormones, it was concluded that the gonadotropinoma became functional, so it was decided to surgically intervene by transcranial approach that resulted in a significant reduction of the tumor lesion (Figures 3(a) and 3(b)).
Micrography of immunohistochemistry staining with Streptavidina-Biotine technique revealed with diaminobenzidine. (a) Nuclear expression of SF-1 in the first surgery ((a), arrows). (b) Intense positivity for the FSH hormone in the second surgery ((b), arrows) (x400).
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Histologically tumors cells arranged in papillary pattern were found (Figures 4(a) and 4(b)).