Figure 1: Pituitary MRI appearances (T1 postgadolinium weighted sagittal images). (a) After the first transsphenoidal operation for macrocorticotropinoma in 2010 with a small tumor remnant. (b) Three years after the first operation. Pituitary adenoma with destruction of the floor of the sella and invasion into sphenoid sinus and both cavernous sinuses. (c) Three months after the initiation of the concurrent therapy with TMZ and radiotherapy. (d) After the 6 cycles of TMZ. Stable pituitary remnant and biochemical control of the disease.