PMC3408871_01
Sagittal and frontal T1 MRI before (A-1 and A-2), and after treatment with Cabergoline (B-1 and B-2).. Notes: MRI of the brain and pituitary gland showed enormous invasive tumor mass lesion is mainly solid with two cystic components at sellar, infra-sellar, and supra-sellar area measures 6.5 x 5.7 x 5.9 cm in its anterior-posterior, transverse, craniocaudal dimensions respectively. The mass displaced the optic chiasm superiorly. Anterior portion shows retrochiasmatic component which is lobulated and shows a small to medium size lobule extending posteriorly to the left CP angle (compressing the the left trigeminal nerve), with another small lobule extending posteriorly to the left orbit through the superior orbit fissure. The two cystic components are noted at the hypothalmic and third ventricle with fluid level (evidence of intra-lesional hemorrhage of the posterior extension of this mass along the left tentorial leaflet and adjacent left lateral border of the brainstem), likely representing pituitary apoplexy.
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MRI 1 year post-treatment showed significant regression in the overall size and extension of the pituitary adenoma with subsequent interval resolution of the mass effect on the suprasellar optic pathway and in the dilatation of third ventricle compared with the previous MRI as shown Figure 1.