59-YEAR-OLD MALE WITH PAMHYPOPITUTISM

摘要

A 59-year-old male teacher developed symptoms of panhypopituitarism. Magnetic resonance imaging revealed a solid homogeneously enhancing mass in the sella measuring 1.8 cm extending into the suprasellar cistern, causing mild compression of the optic chiasm (Figure 1). Neurological exam was normal other than a small bitemporal visual field defect. The lesion was suspected to be a pituitary adenoma, and a transsphenoidal resection was performed. Intraoperatively, the lesion was noted to be posterior to the anterior pituitary gland. Postoperatively, a small amount ofresidual tumor was present that has been stable on follow-up neuroimaging. No adjuvant therapy was given.The resected specimen consisted of a fascicular and storiform arrangement of elongated cells with abundant eosinophilic cytoplasm lacking granularity (Figure 2). The nuclei were spindled and monotonous with fine chromatin and small nucleoli (Figure 3). No mitotic figures were seen. Immunohistochemical studies for chro-mogranin and pituitaryhormones were negative.