Metastatic Pituitary Disease

Clinical History: 
This 53-year-old woman presented to oncology clinic complaining of new-onset headaches over the last week. In particular, these occurred intermittently, involving the region of her right eye. She also reported new-onset diplopia. The patient had a history of cervical cancer with metastatic lesions to her lungs, which were found 6 months previous. The patient’s MR examination is given, and endoscopic transnasal tumor resection was subsequently performed.

Metastatic cervical carcinoma to the pituitary.

MR Technique:
Scans were acquired at 3T Siemens MR unit. (A)Sagittal pre-contrast spin echo T1-weighted(TR/TE 250/2.6ms, scantime 4:48 min:sec) and (B) coronal turbo spin echo T2-weighted(TR/TE 4000/89ms, scantime 3:33 min:sec) scans are displayed, in addition to a (C) sagittal post-contrast T1-weighted scan. The slice thickness was 2 mm in each instance.

Imaging Findings:
A pituitary mass is present, producing significant mass effect upon the optic chiasm with resultant superior displacement of the chiasm to the left of midline. The mass abuts the adjacent cavernous sinus, without definite invasion. Heterogeneous signal intensity is noted throughout the lesion which displays intermediately intense, near homogeneous enhancement on the sagittal post-contrast T1-weighted image.