Pituitary Adenoma? I would greatly appreciate your comment/ opinion? Normal or abnormal pituitary gland?
Male, 50
Pending
Pt has 2 month history of sudden hormone imbalances who is a normally a hypertensive pt on 3 different BP Meds. Very low BP, Excessive water loss (Diabetes Insepidus) Drastic changes of free T4, Borderline high TSH with no history of any thyroid or hormone issues. Very low body temperatures of 95.6, cold sensitivity, lightheadedness, Opaque Photopsia, thyroid US completely Normal
Sagittal
MRI SAG STIR Pituitary Adenoma?
Sagittal
MRI SAG T2 Pituitary Adenoma?
Seems as an incidental finding on a C-Spine MRI. However, clinical symptoms point towards a potential pituitary origin. Based on these limited views could be an adenoma or other entities (Pituicytoma, even a small apoplexy, but signal might be different in that time frame you described).
I suggest doing a pituitary (dynamic) MRI to get a more definite answer.
Pituitary adenomas are pretty frequent - about 10% (mean) of patients based on a study in 2004: https://pubmed.ncbi.nlm.nih.gov/15148823/
Thank you VERY much Dr. Roland :) will do a dynamic MRI of Pituitary and recommend a Pituitary hormone panel as well. Your expertise and comment are greatly appreciated Doctor
I would love your comments and thoughts about the images in this case