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KMID : 1037420090040010029
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Journal of Korean Skull Base Society
2009 Volume.4 No. 1 p.29 ~ p.33
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A Synchronous Pituitary Adenoma and a Diaphragm Sellae Meningioma in Same Patient Mimicking a Pituitary Macroadenoma : Case Report
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Oh Jung-Tae
Chung Seung-Young
Kim Seung-Min
Park Moon-Sun
Jung Sung-Sam
Park Ki-Suk
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Abstract
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The coexistence of a pituitary adenoma and another intracranial tumor is an uncommon finding. We report a rare case of diaphragm sellae meningioma and pituitary adenoma mimicking pituitary macroadenoma in a 41-year-old woman.
The patient presented with bitemporal hemianopsia and was pregnant. Magnetic resonance imaging demonstrated a bright, homogeneously enhancing intra- and suprasellar mass, which was interpreted as a pituitary macroadenoma. Transsphenoidal extirpation was used on 1st operation and Orbitozygomatic craniotomy(transcavernous approach) was done on 2nd operarion because of a suspicion of nonsecreting pituitary macroadenoma. Histopathologically, the tumor was diagnosed as a pituitary adnoma and a meningothelial meningioma. Common carotid angiography before the second surgery revealed that the mass was supplied by the left opthalmic artery. The tumor was near-totally removed via a transcranial route, and she had lost her left vision after a second surgical procedure. It is difficult to make a differential diagnosis between nonsecreting pituitary macroadenomas with suprasellar extension and diaphragma sellae meningiomas preoperatively from the viewpoint of neuroimaging. Preoperative differentiation is essential, because the transsphenoidal approach is used for surgical removal of adenomas, while meningiomas are approached via a craniotomy.
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KEYWORD
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Pituitary adenoma, Diaphragm sellae meningioma, Magnetic resonance imaging
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