1468 AJR:186, May 2006

AJR 2006; 186:1468–1472 0361–803X/06/1865–1468 © American Roentgen Ray Society

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On the AJR ViewboxDOI:10.2214/AJR.05.0329

Ectopic Pituitary Adenoma with an Empty Sella

Pituitary adenoma located in the sinonasalregion is a rare entity. Further, an adenoma inthe sinonasal location associated with an emptysella is extremely uncommon [1]. We report a

case of pituitary adenoma in the paranasal si-nuses and nasopharynx with an empty sella.

A 43-year-old man presented to the ear,nose, and throat department with epistaxis of3 months’ duration. On transnasal endoscopy,a polypoid mass was seen in the region of theposterior choana. On MRI, T1-weighted im-

ages revealed a low-signal-intensity mass inthe sphenoid and ethmoid sinuses extendinginto the nasopharynx, bilateral cavernous si-nuses, and right petrous apex. The pituitarystalk was central extending up to the floor ofthe sella indicating an empty sella (Fig. 1).Contrast-enhanced images showed signifi-

A B

C D

Fig. 1—43-year-old man who presented with epistaxis of 3 months’ duration. On transnasal endoscopy, polypoid mass was seen in region of posterior choana.A and B, T1-weighted images in sagittal (A) and coronal (B) planes reveal low-signal-intensity mass in sphenoid and ethmoidal sinuses extending into nasopharynx, bilateral cavernous sinuses, and right petrous apex. Pituitary stalk was central, extending up to floor of sella indicating empty sella.C and D, Contrast-enhanced images showed significant enhancement of mass.