Cavernous aneurysm and pituitary adenoma: management of dual intrasellar lesions.
A 53-year-old female with a functioning pituitary adenoma was found to also have an unruptured asymptomatic aneurysm in the cavernous sinus portion of the internal carotid artery on MRI. The adenoma had a suprasellar extension with optic chiasm compression and extended into the right cavernous sinus. An aneurysm-like flow-void adjacent to the left internal carotid artery in the sella and embedded in the adenoma was also found. The aneurysm was confirmed by conventional angiography. We used a right fronto-pterional approach to clip the aneurysm and to remove the pituitary tumor in a one-stage procedure. The outcome was good on long-term follow-up. It is important to thoroughly evaluate the anatomic relations around the sella turcica prior to procedures with limited exposure, including transsphenoidal surgery, to avoid unrecognized complications and morbidity.
Yang
Meng-Yin
MY
Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Chen
Clive
C
Shen
Chiung-Chyi
CC
D000236:Adenoma / Q000150:complications* / Q000473:pathology; D000792:Angiography / Q000379:methods; D001164:Arteriovenous Fistula / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000473:pathology; D012658:Sella Turcica / Q000473:pathology*