Borderline variants of the normal pituitary fossa

Endocrinologists tend to accept minor variations of the pituitary fossa as evidence of the presence of a pituitary gland abnormality. Neuroradiologists tend to be sceptical. Normal criteria have not been established. In a consecutive series of 85 cases without any clinical evidence of a pituitary lesion, the plain films in 31.7 per cent demonstrated minor duplication of the floor or anterior wall of the pituitary fossa (with or without associated thinning and possible erosion of the lamina dura), which could be mistaken for the early signs of pituitary enlargement by an intrasellar tumour. 16.5 percent showed thinning of the lamina dura on tomography a feature previously taken as suggesting early enlargement. It is suggested that these particular diagnostic signs should be interpreted with caution.