Planum sphenoidale meningioma leading to visual disturbance.
A 60-year-old male presented with complaints of dizziness, which worsened with fatigue and a sense his balance was 'off'. Initial physical examination was negative and the laboratory testing was unremarkable. Within weeks, the patient developed bilateral visual field deficits. MRI revealed an extra-axial mass which extended into the pituitary fossa and caused compression of the pituitary gland. The pituitary stalk was displaced posteriorly and the optic chiasm was compressed with displacement superiorly and posteriorly. The patient underwent a surgical resection. Diabetes insipidus developed postoperatively requiring a vasopressin drip. He also developed hypopituitarism after the resection with hypothyroidism, hypoadrenalism and hypogonadism. The patient requires testosterone, levothyroxine and hydrocortisone replacement and has mild residual bitemporal hemianopsia.
Department of Emergency Services, VA New York Harbor Healthcare Center, New York, United States. nancy.lutwak@gmail.com
Nancy
N
Lutwak
Curt
C
Dill
Rosemary
R
Wieczorek
D003919:Diabetes Insipidus / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009897:Optic Chiasm / Q000473:pathology; D010902:Pituitary Gland / Q000473:pathology; D013100:Sphenoid Bone / Q000473:pathology; D014786:Vision Disorders / Q000209:etiology*