PMC10392158_01
Preoperative MRI pituitary showed a large precontrast T1 hyperintense sellar-suprasellar cystic and solid mass lesion causing mass effect (red arrow) and upward deviation of the optic chiasm. There is effacement of the lateral ventricles without obvious hydrocephalus (green arrow).. MRI: magnetic resonance imaging.
10.1177_2050313X231190672-fig1.jpg
PMC10392158_01_10.1177_2050313X231190672-fig1.jpg
fig1-2050313X231190672
Magnetic resonance imaging (MRI) of the brain showed a 5.3 cm sellar mass with an upward deviation of the optic chiasm and effacement of the ventricles without obvious hydrocephalus (Figure 1).
The cystic component of the sellar-suprasellar mass demonstrated a fluid-fluid level (red arrow) with a homogenously hyperintense material on T2, layering over a less intense dependent fluid component.
10.1177_2050313X231190672-fig2.jpg
PMC10392158_01_10.1177_2050313X231190672-fig2.jpg
fig2-2050313X231190672
There was a fluid-fluid level consistent with hemorrhage (Figure 2).
Residual mass lesion within the sellar and suprasellar region (red arrow). The center of the lesion is cystic, and the periphery shows nodular enhancement. The optic chiasm is elevated, and the mass lesion reaches up to the floor of the third ventricle.
10.1177_2050313X231190672-fig3.jpg
PMC10392158_01_10.1177_2050313X231190672-fig3.jpg
fig3-2050313X231190672
The initial postoperative MRI showed a residual mass lesion within the sellar and suprasellar region that measured 2.4 x 1.8 cm in size and caused elevation of the optic chiasm (Figure 3).
The sella is expanded and there is herniation of the floor of the third ventricle into the floor of the sella (red arrow). A 1 cm soft tissue is noted along the right anterior superior sella which represents the residual pituitary tissue (green arrow).
10.1177_2050313X231190672-fig4.jpg
PMC10392158_01_10.1177_2050313X231190672-fig4.jpg
fig4-2050313X231190672
The residual pituitary tissue measured 1 cm in size and was located along the right anterior superior sella (Figure 4).