Wk 8, Case 1 - Review

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Report

Patient History
35-year-old woman who presents with blurred vision for the past 2 months.

Findings
There is a mass within the sella extending into the suprasellar space centered to the right of midline with heterogenous hypoenhancement relative to the adjacent pituitary tissue. This measures approximately 19 mm craniocaudad by 18 mm transverse by 20 mm AP and displaces the infundibulum markedly to the left. The mass abuts approximately 180 degrees of the circumference of the cavernous internal carotid artery on the right, a finding equivocal for cavernous sinus invasion. Signal within the left cavernous sinus is normal. The opticchiasm is displaced slightly upwards by the mass, although signal within the chiasm remains normal. The cavernous carotid flow voids are intact.

The visualized intracranial compartment appears unremarkable.

Impressions
Sellar and suprasellar mass most likely reflecting macroadenoma with findings equivocal for invasion of the cavernous sinus on the right. There is mild mass effect on the optic chiasm without abnormal signal in the chiasm.

Case Discussion

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Joshua P Nickerson, MD

Associate Professor of Neuroradiology

Oregon Health & Science University

Francis Deng, MD

Assistant Professor of Radiology and Radiological Science

Johns Hopkins University School of Medicine

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Wk 8, Case 1 - Review