Unsuspected recurrent pituitary adenoma presenting as an orbital mass.
OBJECTIVE
Orbital invasion of pituitary tumors is rare and usually accompanied by optic nerve head pallor and visual loss. We describe a case of unilateral massive orbital invasion by a recurrent pituitary tumor with preserved visual acuity and normal optic nerve appearance.


METHODS
Case report.


RESULTS
Progressive proptosis developed 15 years after transphenoidal removal of a pituitary tumor. Based on the radiological appearance and the clinical history, the patient was suspected to have a sphenoid wing meningioma secondary to previous radiation treatment. A combined neurosurgical and orbital approach was used to remove the intraorbital mass, which extended from the cranial cavity through the superior orbital fissure and the optic canal. Histopathologic examination demonstrated a recurrent nonsecreting pituitary adenoma.


CONCLUSIONS
Orbital extension of a recurrent pituitary adenoma should be considered in the differential diagnosis of progressive proptosis even in the absence of significant optic neuropathy.
Department of Ophthalmology, University of Cincinnati College of Medicine, Ohio, USA.
F P
FP
Bernardini
R C
RC
Kersten
M
M
Moin
D R
DR
Kulwin
D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005094:Exophthalmos / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery