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Washington University Experience | NEOPLASM (SELLAR) | Pituitary Adenoma - Pituitary Neuroendocrine Neoplasm | MRI | 9A0 Case 9 History
Case 9 History ---- The patient is a 56-year-old woman who developed confusion, dizziness, impaired memory, and decreased sense of smell. Magnetic resonance imaging reveals a large enhancing midline mass within the paranasal sinuses, nasal cavity, and nasopharynx, that extends intracranially into the anterior and middle cranial fossae, sellar and suprasellar spaces, and cavernous sinus. Biopsy of the mass in the left nasal cavity by the department of Otolaryngology yielded a diagnosis of pituitary adenoma. Histological sections of the "pituitary tumor" in the current resection show fragments of a neoplasm with histomorphological characteristics similar to those of the patient's previous left nasal cavity biopsy specimen, which was reviewed. The neoplastic cells were positive for synaptophysin, chromogranin, and the pituitary hormones LH, FSH, TSH and prolactin. ACTH and GH were negative. A reticulin stain showed large nests and islands of cells. Immunohistochemistry for S100, Melan-A, cytokeratin, epithelial membrane antigen, CAM5.2, and desmin were negative. Only rare positive cells were identified on KI-67 and p53 stained sections.
