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Case of the Month - July  2018

Patient with visual acuity deterioration, with bilateral visual field defect. With hypothyroidism, Rest of the hormonal panel within normality. 

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Patient underwent endoscopic transsphenoidal endonasal resection, with final diagnosis non-producing pituitary adenoma.

How to classify pituitary adenomas?

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Size

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  • Picoadenoma​ <5mm

  • Microadenoma <1cm

  • Macroadenoma> 1cm

  • Giant adenoma> 4cms

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Type

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  • Hormone producer (functional)

    • Prolactinoma​

    • Growth hormone (acromegaly)

    • ACTH (Cushing's disease)

  • Non-hormone producer

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Knops Classification (Lateral Cavernous Sinus Involvement)

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  • G0 without sinus involvement

  • G1 adenoma of  midline, intracarotid (relative to internal carotid artery)

  • G2 more than midline

  • G3 over lateral line of internal carotid artery

  • G4 fully encompasses the intracavernous internal carotid artery

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References

 

1. Kunam VK, et al.  Incomplete Cord Syndromes: Clinical and Imaging Review.  Radiographics.  2018 Jul-Aug; 38 (4): 1201-1222. doi: 10.1148 / rg.2018170178.

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