PMC6920587_01
Endoscopic view of right nasal cavity showing mass extending down from
sphenoethmoidal recess to the nasal floor.
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Nasal endoscopy revealed a right lobulated sinonasal mass with pale mucosa and prominent blood vessels (Figure 1).
Magnetic resonance imaging of brain showed a large lobulated enhancing soft
tissue mass at the sellar region extending anteriorly to the sphenoid and
ethmoidal sinus, laterally to the cavernous sinus and the right carotid
artery (A and B) and the extension of mass into the nasal cavity (C).
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Magnetic resonance imaging (MRI) showed similar findings (Figure 2).
The tumor cells mainly arranged in sheets, consisting of monomorphic
medium-sized cells with oval to round hyperchromatic nuclei (seen under
H&E x100 magnification). Similar group cells with higher magnification
(H&E, x400 magnification) showing hyperchromatic nuclei with moderate
bubbly cytoplasm and some cells appear plasmacytoid.
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Further immunohistochemical analysis for pituitary hormones confirmed a corticotroph adenoma (Figure 3).