FIGURE 5-1

FIGURE 5-2

FIGURE 5-3

FIGURE 5-4

FIGURE 5-5

FINDINGS Figure 5-1. Sagittal post-contrast T1WI. There is a large inhomogeneous sellar mass with suprasellar extension and invasion of the sphenoid sinus (arrow). Figure 5-2. Two months later, a post-contrast axial T1WI shows bilateral cerebellar masses (arrows) that are metastases consistent with metastatic pituitary carcinoma. Figure 5-3. Axial NCCT in a companion case of invasive pituitary adenoma (PA) shows destruction of the central bony skull base (arrows). Figure 5-4. Sagittal post-contrast T1WI in the companion case. There is a large enhancing sellar mass with invasion of the sphenoid sinus and extension into the posterior nasal cavity (arrows). Figure 5-5. Coronal post-contrast T1WI shows invasion of both cavernous sinuses by the sellar mass (arrows).

DIFFERENTIAL DIAGNOSIS Meningioma, metastasis, clival chordoma, chondrosarcoma, plasmacytoma, malignant macroadenoma.

DIAGNOSIS Malignant macroadenoma.

DISCUSSION

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