Pituitary prolactinoma | Figure 1

CincyKidsRad
Cincinnati Children's Radiology

Pituitary prolactinoma

Sagittal T1 (image 1), coronal T2 (image 2), sagittal (image 3), and coronal (image 4) T1-weighted post-contrast MRI show a pituitary adenoma (arrow). Prolactinomas are the most prevalent type of functioning pituitary adenoma. Presenting symptoms may include headaches, visual field deficits, and hyperprolactinemia-related symptoms. In children and adolescents, symptoms include growth arrest, delayed puberty, and primary amenorrhea in girls.

Similar cases

Sagittal T1-weighted MRI through the left (image 1) and right (image 2) cerebellar hemisphere and axial T1-weighted (image 3) MRI in a patient with ataxia show diffuse cerebellar atrophy with widening of the cerebellar folia and cerebellar vermis. Spinocerebellar ataxia is a degenerative hereditary disorder. Patients initially present with ataxia. Other symptoms included difficulty of speech and swallowing, spasticity, ophthalmoplegia, nystagmus, and cognitive impairment.

Coronal (image 1) and sagittal (image 2) T1-weighted images focused on the pituitary show a thickened proximal infundibulum (arrow) with increased signal and narrowing distally. Langerhans' cell histiocytosis can rarely affect the central nervous system. When the central nervous system is affected, it most commonly appears as thickening of the infundibulum. Patients may present with diabetes insipidus.

Axial (image 1), coronal (image 2), and sagittal (image 3) T1-weighted post-contrast MRI focused on the pituitary show thickening of the infundibulum (arrow) and enlargement of the pituitary (arrowhead). Langerhans cell histiocytosis rarely affects the central nervous system. When it does, patients may present with diabetes insipidus, ataxia, or hydrocephalus. Diabetes insipidus is a common manifestation when the posterior pituitary and infundibulum are infiltrated by Langerhans cells. Infundibular thickening greater than 3 mm is suggestive of involvement.

Sagittal (image 1) and axial (image 2) T1-weighted and coronal T1-weighted postcontrast (image 3) MRI show a hypothalamic hamartoma (arrow). The normal pituitary (arrowhead) is shown nearby. Hypothalamic hematomas are nonprogressive tumors that grow in proportion to the normal brain. Symptoms typically occur in childhood and include central precocious puberty or gelastic seizures.