Fig. 1

Initial imaging examinations of the 64-year-old man obtained from the outside hospital. A An unenhanced computed tomography image showed the typical “snowman” or “figure of 8” configuration of pituitary macroadenoma with internal hyperdense areas consistent with acute haemorrhage within the tumour (white arrow). B-C This haemorrhagic macroadenoma was confirmed on magnetic resonance images obtained 1 day later. The foci of haemorrhage were isointense to slightly hyperintense (white arrow) on unenhanced T1-weighted imaging (B) and hypointense (white arrow) on T2-weighted imaging (C). The tumour was found to be encasing the normally sized left cavernous internal carotid artery (black arrow in (B)) and invading the left cavernous sinus (asterisk in (C)). C The optic chiasm (thin white arrow) was elevated by the suprasellar part of the tumour