Neuroimaging: pituitary adenoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: pituitary adenoma

Sample item

A patient with bitemporal hemianopia has MRI showing a large sellar mass that indents the optic chiasm and extends into the suprasellar cistern, giving a 'figure of 8' or snowman appearance. What is the diagnosis?

APituitary macroadenomaBMeningioma of the olfactory grooveCCraniopharyngiomaDRathke cleft cyst

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Pituitary macroadenoma

A macroadenoma is above 10 mm in size and constricts at the diaphragma sellae to produce a waist, giving the snowman sign. Enlargement of the sella with erosion is typical. Craniopharyngioma often shows calcification and cystic parts in children.

Option by option

A. Pituitary macroadenoma (correct)
Correct. A sellar mass with suprasellar extension and waist is a macroadenoma.
B. Meningioma of the olfactory groove
An olfactory groove meningioma is anterior to the chiasm.
C. Craniopharyngioma
A craniopharyngioma is suprasellar and calcified with cystic components.
D. Rathke cleft cyst
A Rathke cleft cyst is a small non-enhancing cyst.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Pituitary macroadenoma. A macroadenoma is above 10 mm in size and constricts at the diaphragma sellae to produce a waist, giving the snowman sign.

Why is "Meningioma of the olfactory groove" not the answer?

An olfactory groove meningioma is anterior to the chiasm.

Why is "Craniopharyngioma" not the answer?

A craniopharyngioma is suprasellar and calcified with cystic components.

Why is "Rathke cleft cyst" not the answer?

A Rathke cleft cyst is a small non-enhancing cyst.

What concept does this question test?

It tests Neuroimaging: pituitary adenoma in Radiology. Enlargement of the sella with erosion is typical. Craniopharyngioma often shows calcification and cystic parts in children.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: pituitary adenoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.