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Contributed by Volkmar H.J. Hans MD1, Horst Urbach MD2, Rudolf A. Kristof MD3, Martina Deckert MD1 |
| 1Institute for Neuropathology, 2Division of Neuroradiology and 3Department of Neurosurgery, University Hospital, Bonn, Germany | |
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Published on line in January 2002 |
CLINICAL HISTORY:
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A 59-year-old woman presented with a three-year history of right-frontal headache and fatigue. A cystic follicular adenoma of the thyroid had been resected 13 years before and a right frontal meningothelial meningioma (WHO Grade I) 17 months before. Neurological examination was unremarkable. GH response upon GHRH stimulation was reduced (GH basal 4.2 ng/ml, stimulated 7.2 ng/ml). The other pituitary and organotropic hormones showed physiological serum concentrations.
MRI studies disclosed an intrasellar non contrast-enhancing lesion 0.8 cm in diameter in a right paramedian location, lifting the sellar diaphragm and displacing the normal pituitary gland to the left. The signal intensity was like cortical gray matter on the T1-weighted MRI scans (Fig. 1). Coronal images of T1-weighted (TR 30ms, TE 7.6ms) MRI scans of the sellar region before (2A) and after Gd-DTPA enhancement (2B).
The patient underwent an uncomplicated transsphenoidal resection of a firm tumor that was readily separated from surrounding adeno- and neurohypophysis.
International Society of Neuropathology