PMC6357293_01
Changes in plasma cortisol after dynamic endocrine tests.
10.1177_1179551419825832-fig1.jpg
PMC6357293_01_10.1177_1179551419825832-fig1.jpg
fig1-1179551419825832
Table 2.Plasma cortisol increases after the DDAVP test and cortisol decreases after 8 mg of nocturnal dexamethasone suggested Cushing disease (Figure 1). A pituitary magnetic resonance image (MRI) was obtained revealing a large mass (36 x 46 x 46 mm) in the skull base centered in the sphenoid sinus with caudal extension in the nasopharynx and posterior extension in the clivus.
A contrast-enhanced magnetic resonance image of the brain showing a large mass in the skull base involving the sella and extending in the nasopharynx the clivus.
10.1177_1179551419825832-fig2.jpg
PMC6357293_01_10.1177_1179551419825832-fig2.jpg
fig2-1179551419825832
The mass completely involved the sella (preventing pituitary gland identification) although without compromising the pituitary stalk and the optic chiasm (Figure 2). The mass was also identified with an Indium-111 octreotide scan confirming somatostatin receptor expression.
A magnetic resonance image of the brain 1 year after radiotherapy showing the stability of the tumor size.
10.1177_1179551419825832-fig3.jpg
PMC6357293_01_10.1177_1179551419825832-fig3.jpg
fig3-1179551419825832
A new MRI revealed mass stability persisting in the last follow-up 1 year after radiotherapy (Figure 3).