Pituitary adenoma presenting with nasal obstruction: A case report
Bibliographic record
Abstract
A 58-year-old lady presented with worsening congestion, nasal obstruction, and hyposmia. After failing medical therapy, a computed tomography (CT) scan was ordered which demonstrated a large tumor (6.1 cm × 3.9 cm x 5.2cm) in the nasal cavity. There was erosion through the skull base superiorly and the clivus inferiorly (Fig. 1). At this point she was referred to our center where she underwent endoscopic biopsies that demonstrated a pituitary adenoma. Formal visual testing showed decreased visual acuity in the right eye. She then underwent successful endoscopic resection of the tumor with significant improvement clinically. Pituitary adenomas are relatively common lesions and represent approximately 15% of all intracranial neoplasms. The presentation can be varied, but often patients present with headache, endocrinological disturbances, or visual changes. Nasal obstruction is a very rare presentation of a pituitary adenoma, but has been described in the literature, first being described in 1910. In the workup of a large nasal mass, imaging and histological exam is essential. The differential for nasal obstruction is large, but pituitary tumors (including adenoma) should be on the differential and kept in the back of the mind whenever a patient presents with a large posteriorly-based sinonasal mass.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.009 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".