approach to pituitary masses
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Magnetic
resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Pilomyxoid astrocytoma in a 4-month-old baby girl. Sagittal T1WI (a) shows a large hypothalamic lesion with intermediate signal which extends superiorly into and filling the third ventricle, and inferiorly into the suparsellar cistern. The tumour has mostly high signal on axial T2WI (b)
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Pituitary
microadenoma • Pituitary microadenoma - Ganzer Fall bei Radiopaedia
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Pituitary
tumors • Pituicytoma - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Mucocele of the sphenoid sinus - Ganzer Fall bei Radiopaedia
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Teenager with
hyperprolactinemia. 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.The diagnosis was pituitary microadenoma.
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Spindle cell
oncocytoma of the adenohypophysis in a woman: a case report and review of the literature. (A) Coronal magnetic resonance imaging studies showing a sellar mass with suprasellar extension but no invasive growth (arrow). (B) T1-weighted image showing the enhancement of the mass (arrow).
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Clinical
features, radiological profiles, pathological features and surgical outcomes of pituicytomas: a report of 11 cases and a pooled analysis of individual patient data. Radiological features of pituicytomas. a. The tumor is completely located in the intrasellar region. b. The tumor is located in the intrasellar-suprasellar region. c. The tumor is completely located in the suprasellar region. d. Pituicytoma invading the right cavernous sinus. The lesion surrounded the internal carotid artery, and the optic chiasm was not compressed. e. The optic chiasm was oppressed and elevated by the tumor, and the cavernous sinus was not involved. f. Pituicytoma invading the right cavernous sinus; the optic chiasm was compressed, and the tumor was accompanied by cystic degeneration
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A rare case
of pituicytoma-related hypercortisolism in a patient with Cushing syndrome—case report. MRI T1-weighted sagittal view of non-enhancing 0.46 × 0.33 cm focus of low signal in the left central portion of the pituitary gland on the post-contrast
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A rare case
of pituicytoma-related hypercortisolism in a patient with Cushing syndrome—case report. MRI T1-weighted coronal view same non-enhancing 0.46 × 0.33 cm pituitary lesion
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A rare case
of pituicytoma-related hypercortisolism in a patient with Cushing syndrome—case report. MRI T1-weighted coronal view same non-enhancing 0.46 × 0.33 cm pituitary lesion and an arrow indicating the thickening of the pituitary stalk
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Magnetic
resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Glioma in a 2-year-old girl with neurofibromatosis type 1. Sagittal (a) and axial (b) post contrast T1WI shows a partially enhancing lesion enlarging the optic chiasm and proximal optic nerves
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Magnetic
resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Teratoma. Sagittal T1WI (a) and axial T2WI (b) show a lesion at the undersurface of the hypothalamus which has mixed low, intermediate and high signal. Axial CT image (c) shows the lesion to contain zones of calcification, fat and intermediate soft-tissue attenuation
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Teenager with
short stature. 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.The diagnosis was pituitary macroadenoma.
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Magnetic
resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Germ cell tumours in two different children. Post-contrast T1WI (a) shows a large enhancing lesion in the suprasellar cistern extending superiorly into the third ventricle and posteriorly into the prepontine cistern. Sagittal post-contrast T1WI (b) in another child shows enhancing, disseminated germ-cell tumour in the suprasellar cistern, third and lateral ventricles, with involvement of the corpus callosum and optic chiasm
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Magnetic
resonance imaging of sellar and juxtasellar abnormalities in the paediatric population: an imaging review. Enthesioneuroblastoma. Sagittal T1WI (a) and post-contrast T1WI (b) show a destructive mass lesion involving the sphenoid bone which invades the sphenoid sinus and sella. The tumour shows prominent, mildly heterogeneous contrast enhancement
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Extraventricular
neurocytoma of the sellar region: case report and literature review. The pre- and post-operative MRI. a–d Preoperative MRI showing a intrasellar and suprasellar tumor extending to anterior skull base and superior clivus. e, f The postoperative enhanced MRI showing subtotal tumor removal, with a little tumor remained in the intrasellar region
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Pituitary
region masses • Adamantinomatous craniopharyngioma - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Pituitary macroadenoma - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Suprasellar teratoma - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Pituitary fossa meningioma - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Rathke's cleft cyst - Ganzer Fall bei Radiopaedia
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Pituitary
region masses • Suprasellar giant aneurysm - Ganzer Fall bei Radiopaedia
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Pituitary
region mass (mnemonic) • Pituitary metastasis - Ganzer Fall bei Radiopaedia
A simple and popular mnemonic to remember the common suprasellar/parasellar/intrasellar masses is SATCHMO. The more comprehensive list includes:
- tumors
- pituitary adenoma (commonest in the adult population)
- pituitary carcinoma
- pituitary lymphoma
- meningioma
- craniopharyngioma
- hypothalamic astrocytoma/glioma
- chiasmatic astrocytoma
- optic nerve glioma
- germinoma
- chordoma
- dermoid (CNS)/epidermoid/intracranial teratoma
- pituicytoma
- spindle cell oncocytomas
- pituitary metastases
- granular cell tumor of the pituitary (pituitary choristoma)
- pilocytic astrocytoma of the neurohypophysis (infundibuloma)
- metastasis: from breast, lung, kidney, gastrointestinal tract and nasopharynx
- granuloma (TB, syphilis, giant cell granuloma, eosinphilic granuloma)
- hamartoma of tuber cinereum
- cellular infiltrates
- other lesions
- anterior circulation berry aneurysm
- hamartoma (tuber cinereum hamartoma)
- Rathke cleft cyst
- intracranial lipoma
- sphenoid sinus mucocoele
- pituitary abscess
- pituitary stone
- carotido-cavernous fistula
It is also helpful to consider differentials narrowed by pattern of MRI appearance.
- solid and enhancing pituitary region mass
- mixed cystic and solid pituitary region mass
- cystic pituitary region mass
- purely intrasellar pituitary mass
- pituitary region mass with intrinsic high T1 signal
- abnormal enhancement/bulkiness of the pituitary infundibulum
Siehe auch:
- Tuberkulose
- Meningeom
- Hirnmetastase
- Raumforderungen des Clivus
- Pilozytisches Astrozytom
- Aneurysma
- Teratom
- Rathke Zyste
- Chordom
- verdickter Hypophysenstiel
- Makroadenom Hypophyse
- Chiasma opticum
- ektope Neurohypophyse
- Hypophyse
- intrakranielle Lipome
- Kraniopharyngeom
- Pituitary MRI (an approach)
- Keimzelltumor
- Mikroadenom Hypophyse
- Germinom
- Sinus cavernosus
- Hypophysenadenom
- Erdheim-Chester-Erkrankung
- cystic meningioma
- Nervus opticus
- hypothalamisches Hamartom
- dritter Ventrikel
- intrakraniale Teratome
- Epidermoid
- pituitary region mass with intrinsic high T1 signal
- Autoimmunhypophysitis
- pituitary metastasis
- Opticusgliom
- hypothalamic lesions
- solid and enhancing pituitary region mass
- Histiozytose
- Cisterna chiasmatica
- Granularzelltumor
- mixed cystic and solid pituitary region mass
- intrakranielle Dermoidzyste
- normal bone marrow signal of the clivus
- purely intrasellar pituitary mass
- granular cell tumour of the pituitary
- Spindelzell-Onkozytom der Hypophyse
- Pituizytom
- skeletale Manifestationen der Langerhanszell-Histiozytose
- zystische Läsionen der Sellaregion
- sakkuläre zerebrale Aneurysmata
- supraselläres Teratom
- SATCHMO
- cleft cyst
- hypothalamic astrocytoma / glioma
- meningioma, metastasis
- kongenitale Anomalien der Hypophyse
- Langerhans-Zell-Histiozytose der Hypophyse
- Xanthogranulom der Hypophyse
- suprasellar lipoma
- supraselläres Germinom
- supraselläres Gangliogliom
und weiter:
- Tumoren der Hypophysenregion
- Akromegalie
- Einklemmung
- suprasellar cistern lipoma
- acquired intracranial herniation
- Hypophysenstiel
- metastases to the pituitary gland
- Chiasma-Syndrom
- zystische Läsionen in der Hypophyse
- Galaktorrhö-Amenorrhö-Syndrom
- intracranial choriocarcinoma
- mostly / purely cystic pituitary region masses
- suprasellar / hypothalamic lesions
- Pubertas praecox
- teratoma suprasellar
- transsphenoidale Hypophysektomie
- Hypophysitis
- Apoplex der Hypophyse
- Fröhlich-Syndrom
- adamantinomatous craniopharyngioma
- planum sphenoidale meningioma
- cystic craniopharyngioma
- Hypophysenkarzinom
- Hypophysenadenom Kalk
- papillary craniopharyngioma
- kongenitale Anomalien der Sellaregion
- Hypophysentumor Estradiol
- Duplikation der Hypophyse
- Gangliogliom des Nervus opticus
- Germinom des ZNS
- Teratom der Hypophyse
- intracranial germ cell tumours
- intrakranieller Keimzelltumor
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skeletale
Manifestationen der Langerhanszell-Histiozytose