A 31-year-old woman with a history of prolactinoma was admitted at the 39th week of her first pregnancy for headache and nausea. She had been receiving bromocriptine until she became pregnant. The neurologic examination, which included a dilated fundus examination and visual-field screening, was normal. Magnetic resonance imaging (MRI), consisting of a T2-weighted image in the axial plane (Panel A) and a T1-weighted image in the midsagittal plane (Panel B), revealed an intrasellar mass with suprasellar extension (arrows) and fluid levels consistent with recent bleeding into the macroadenoma. These findings are typical of pituitary-tumor apoplexy. Pituitary-tumor apoplexy is an acute hemorrhagic infarction of a preexisting pituitary adenoma. It often results from the short-term expansion of an adenoma, which occurs frequently during pregnancy. It can result in sudden, severe headache, visual disturbances, and impairment of pituitary function. Computed tomography and MRI confirm the diagnosis.
what is this tumor ?
Discuss management of this patient ?