The Small Sella and the Bulging Pituitary Gland

A small sella is a frequent cause of concern if not recognized. It is responsible of an upward bulging of the pituitary gland simulating pituitary hyperplasia or a PitNET. This condition is particularly disturbing with coexistence of a small sella and a true temporary pituitary hyperplasia such as in adolescent girls. A small sella is usually due to a hyperpneumatization of the sphenoid sinus or to a short transverse diameter of the skull and of the sphenoid. A sellar floor <10 mm on coronal view indicates a small sella.