International Journal of Clinical & Medical Images

A 50-year-old man admitted in emergency OPD at Osmania Medical College, Hyderabad, Telangana complaining of head injury on June 2018. He had no external injuries except small swelling over the scalp (right parietal region). Duty doctor at emergency OPD planed X-ray skull lateral view to rule out any bony defect. In that X-ray we found enlargement of sellaturcica. It is a saddle-shaped concavity in the body of sphenoid bone. Then we suspected pituitary macroadenoma. He was also heavy in built and having visual problems strengthening our suspicion. We have done MRI brain next day. MRI showed Pituitary macroadenoma. He was started on medical treatment according to endocrinologist opinion. After 1 year he had surgery for increasing visual defects and non-responding to medical treatment. Pituitary adenomas are most common neoplasms in elder age group. MRI is the best and index modality to diagnose them. Treatment usually surgery and medical therapy depending on type, size of tumour and clinical symptoms. However, in above case it was accidental finding on X-ray. The above case was highlighted the importance of X-ray as a screening tool in suspected pituitary macroadenoma cases (Figure 1).