PMC8422539_01
Case 1 preoperative contrast-enhanced T1-weighted MRI scan: (a) sagittal; (b) coronal. Arrows delineate the thin rim of normal pituitary gland draped superiorly over the tumor.
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F1
An MRI of the pituitary was subsequently performed and showed a large sellar and suprasellar mass displacing the optic chiasm upwards, consistent with a pituitary macroadenoma [Figure 1].
Case 1 2-month postoperative contrast-enhanced T1-weighted MRI scan: (a) sagittal; (b) coronal. Arrows delineate the proximal and distal aspect of the pituitary stalk.
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F2
His postoperative MRI taken 1 month following surgery revealed a marked descent of the residual pituitary gland to the floor of the sella, with either severe stretching or complete disruption of the pituitary stalk [Figure 2].
PMC8422539_02
Case 2 pituitary MRI scan: (a) preoperative sagittal noncontrast-enhanced T1-weighted image, (b) preoperative sagittal contrast-enhanced T1-weighted image, (c) preoperative coronal noncontrast-enhanced T2-weighted image pituitary. Note the fluid-fluid level within the sella in each, consistent with subacute hemorrhage.
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F3
A pituitary MRI revealed a 2.2 cm x 2.4 cm x 4.0 cm cystic sellar mass, with suprasellar extension [Figure 3].
Case 2 postoperative pituitary MRI scan. (a) Contrast-enhanced T1-weighted sagittal image, (b) contrast-enhanced T1-weighted coronal image, (c) coronal noncontrast-enhanced T2-weighted image. Arrows delineate the proximal pituitary stalk, with no distal stalk remnant seen.
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F4
An MRI obtained at that time, due to the new symptoms, revealed a marked descent of the residual pituitary gland and diaphragma sellae down to the floor of the sella, with severe thinning and apparent discontinuity of the pituitary stalk [Figure 4].