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.
Bernardini
F P
FP
Department of Ophthalmology, University of Cincinnati College of Medicine, Ohio, USA.
Kersten
R C
RC
Moin
M
M
Kulwin
D R
DR
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