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Clinical Report

Pituitary Macroadenoma

Dr. Michael R. Chicoine, Associate Professor, Neurological Surgery
Washington University School of Medicine & Siteman Cancer Center
Barnes Jewish Hospital, St Louis, Missouri

PATIENT INFO: 64 year-old female presenting with visual difficulty and bitemporal hemianopsia

SUMMARY: This case involved a large sellar mass with suprasellar extension which was later confirmed to be a nonfunctioning pituitary adenoma. The surgeon elected to perform a transnasal, transsphenoidal endoscopic resection. The intraoperative MR images demonstrated residual tumor particularly in the left aspect of the sella. Based on this information the decision was made to perform additional resection. The intraoperative MRI scans were transferred to the surgical navigation system and were used to guide the additional resection. There has been no evidence of tumor recurrence in the 14 months following surgery.

Due to its large size, the entire area of the tumor was not clearly visual to the surgeon’s eye. Intraoperative MRI revealed the extent of the tumor and allowed for a more complete resection.