Pediatric Pituitary Macroadenoma

  • Etiology: Pituitary tumor greater than 10 millimeters in size that is intrasellar in origin
  • Imaging MRI:
    — T1WI: Lesion is isointense to gray matter
    — T1WI post contrst: Lesion enhances intensely
    — T2WI: Lesion is isointense to gray matter on T2WI
  • DDX: Rathke cleft cyst, craniopharyngioma, adolescent girls can have enlarged pituitary gland due to hormonal stimulation
  • Complications: Can invade cavernous sinus
  • Treatment: Surgical
  • Clinical:
    — Most common pituitary adenoma in pediatric population
    — May present with mass effect on optic chiasm
    — Most commonly a functioning tumor with prolactin being most common in pediatric age group

Radiology Cases of Pituitary Macroadenoma

MRI of pituitary macroadenoma
Sagittal (above) and coronal (below) T1 MRI with contrast of the sella shows a large homogenous solid mass arising in the sella and extending superiorly into the suprasellar region that shows homogenous enhancement with contrast.