Female, 19 years old, with weight gain, secondary amenorrhea, elevated urine free cortisol, elevated salivary cortisol, responded to dex suppression CRH stimulation. A 3 x 2 x 2 mm focus of hypoenhancement is seen within the superior left aspect of the pituitary gland. The gland shows generally heterogeneous enhancement posteriorly, but is otherwise normal in size and morphology. The pituitary stalk enhances normally and enters the gland at midline. No suprasellar encroachment is seen. No significant abnormality is detected elsewhere in the visualized brain.
A focal region of hypoenhancement within the superior left aspect of pituitary gland could represent a microadenoma as clinically suspected. Generally heterogeneous enhancement of the posterior aspect of the gland may also be related, or this may be an incidental variation.