Snapshot A 68-year-old woman presents to the emergency room with profound hypovolemia. She is given IV fluids and also complains of a headache that has been plaguing her for a year but attributed it to severe migraines. It is continuous; however, it seems to have gotten worse recently. She also reports recent weight gain. On physical exam, she has notably slow deep tendon reflexes with facial myxedema. Serum labs come back with hypoglycemia and hyperkalemia. Concerned for possibility of a pituitary lesion, she is sent for a CT scan of the head. Introduction Benign brain tumor arising from Rathke pouch Epidemiology Most common childhood supratentorial tumor Bimodal distribution login to view 2 more bullets etiology Pathogenesis login to view 8 more bullets Presentation Symptoms/physical exam login to view 18 more bullets IMAGING CT scan with contrast for diagnosis login to view 1 more bullet MRI to assess surgical approach STUDIES Histology login to view 2 more bullets Assessment of endocrine function if suspicious login to view 5 more bullets Differential Diagnosis Pituitary adenoma Glioma Medulloblastoma Meningioma Treatment Surgical resection If not completely resectable login to view 1 more bullet Prognosis, Prevention, and Complications Prognosis login to view 4 more bullets Complications login to view 1 more bullet