Gonadotropin-Secreting Pituitary Macroadenoma Complicated With Hemorrhagic Apoplexy in 18F-FDG PET/CT

Abstract

We report the case of 69-year-old man referred for a stage IV pulmonary adenocarcinoma and presenting a decrease in visual acuity. An 18F-FDG PET/CT showed an intense and heterogeneous uptake of a mass in the sellar region. An MRI showed a pituitary macroadenoma associated with a large cyst on the left side, with necrosis zones and fluid level, compressing the optic chiasma. Endocrine testing showed a panhypopituitarism, and pathology confirmed a pituitary apoplexy in a gonadotropin-secreting macroadenoma. No malignant cells were detected. Molecular imaging could have an important role in the detection and characterization of pituitary tumors.

Incidental 18F-Florapronol Uptake in Pituitary Adenoma

“…In prolactinoma, amyloid deposition is associated with the effect of dopamine agonist therapy, 6 but its significance in NFPA is unclear. Several studies have reported the FDG avidity of NFPAs 7–9 . In clinical practice, less than 0.1% of patients showed incidental FDG uptake of NFPA revealed in the large retrospective cohort studies 10,11 .…”