A macroadenoma during surgery is shown in Fig. 4.10. The patient in the example had a mass effect with bitemporal hemianopia. The figure shows the large tumour immediately upon opening the dura, before any of the tumour has been removed (Fig. 4.10(a)), as well as the tumour completely excised leaving the thin pituitary gland intact (Fig. 4.10(b)). The bluish structure, anterior to the gland, is the diaphragma sellae. In this case, the removal of a moderately large adenoma was achieved with preservation of the gland.
