Pediatric Pituitary Microadenoma

  • Etiology: Pituitary tumor less than 10 millimeters in size that is intrasellar in location
  • Imaging MRI:
    — T1WI: Lesion is isointense to normal pituitary
    — T1WI post contrast: Dynamic post contrast shows round region of delayed enhancement compared to rest of pituitary gland, delayed post contrast variable from hypo-enhancement (most common) to isointense to hyperintense
    — T2WI: Lesion is slightly hyperintense
  • DDX: Rathke cleft cyst (do not enhance), craniopharyngioma (rarely purely intrasellar, usually larger, calcification common)
  • Complications:
  • Treatment: Medical management
  • Clinical:
    — Do not produce symptoms due to mass effect
    — Produce symptoms of excess production of one or more hormones

Radiology Cases of Pituitary Microadenoma

MRI of pituitary microadenoma
Sagittal (above) and coronal (below) T1 MRI with contrast of the sella shows a small mass in the midline of the sella that enhances less than the surrounding pituitary gland.