Figures
![Figure 1.](http://www.jofem.org/tables/jem295w-g001.jpg)
Figure 1. Confluent mediastinal and right hilar adenopathy, likely represent metastatic disease. Peribronchovascular infiltrates in the right lower lobe.
![Figure 2.](http://www.jofem.org/tables/jem295w-g002.jpg)
Figure 2. There is a 2.6 × 1.2 × 1.3 sellar mass with intermediate signal intensity on T1 and T2-weighted images inseparable from pituitary gland and compressing optic chiasm. The mass abuts the right cavernous sinus without definite invasion.
![Figure 3.](http://www.jofem.org/tables/jem295w-g003.jpg)
Figure 3. EBUS showing the biopsy taken from right hilar lymph node.
![Figure 4.](http://www.jofem.org/tables/jem295w-g004.jpg)
Figure 4. Immunostains from EBUS showing ER+.
![Figure 5.](http://www.jofem.org/tables/jem295w-g005.jpg)
Figure 5. Pituitary mass histology revealed metastatic breast cancer with cytokeratin, ER, PR positive and Her 2 negative staining.
![Figure 6.](http://www.jofem.org/tables/jem295w-g006.jpg)
Figure 6. Bone marrow biopsy showed hypocellular marrow with normal M:E ratio with clusters of atypical cells positive for cytokeratin and ER receptors.
![Figure 7.](http://www.jofem.org/tables/jem295w-g007.jpg)
Figure 7. CT head showing moderate bilateral subdural effusions with early descending transtentorial herniation bilaterally.