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Journal of Korean Neurosurgical Society 2001;30(4): 519-521.
A Sedimentation Level in Pituitary Adenoma on Magnetic Resonance Imaging.
Young Rae Kim, Jun Hyeok Song, Hyang Kwon Park, Sung Hak Kim, Kyu Man Shin
Department of Neurosurgery, College of Medicine, Ewha Women's University, Seoul, Korea.
We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.
Key Words: Pituitary apoplexy; Sedimentation level
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