title: Pituitary macroadenoma presenting as a nasal tumor: case report.
abstract: BACKGROUND
  Pituitary macroadenomas are rare intracranial tumors. In a few cases, they may present aggressive behavior and invade the sphenoid sinus and nasal cavity, causing unusual symptoms. In this paper, we report an atypical case of pituitary adenoma presenting as a nasal mass.
  
  
  METHODS
  The patient was a 44-year-old woman who had had amenorrhea and galactorrhea for ten months, with associated nasal obstruction, macroglossia and acromegaly. Both growth hormone and prolactin levels were increased. Magnetic resonance imaging showed a large mass originating from the lower surface of the pituitary gland, associated with sella turcica erosion and tumor extension through the sphenoid sinus and nasal cavity. Histopathological analysis demonstrated a chromophobe pituitary adenoma with densely packed rounded epithelial cells, with some atypias and rare mitotic figures. There was no evidence of metastases.
  
  
  CONCLUSIONS
  Macroadenoma invading the nasal cavity is a rare condition and few similar cases have been reported in the literature. This study contributes towards showing that tumor extension to the sphenoid sinus and nasopharynx needs to be considered and investigated in order to make an early diagnosis when atypical symptoms like nasal obstruction are present.
authors.affiliation: Department of Radiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Nivaldo Adolfo
authors.initials: NA
authors.lastname: Silva Junior
authors.affiliation: Department of Radiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Reis
authors.affiliation: Department of Radiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Larissa Kaori
authors.initials: LK
authors.lastname: Miura
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Guilherme Henrique
authors.initials: GH
authors.lastname: Vieira
authors.affiliation: Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Luciano Souza
authors.initials: LS
authors.lastname: Queiroz
authors.affiliation: Department of Endocrinology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Heraldo Mendes
authors.initials: HM
authors.lastname: Garmes
authors.affiliation: Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Cristina Laguna
authors.initials: CL
authors.lastname: Benetti-Pinto
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008279:Magnetic Resonance Imaging; D009296:Nasal Cavity / Q000473:pathology* / Q000601:surgery; D015508:Nasal Obstruction / Q000209:etiology; D009361:Neoplasm Invasiveness / Q000473:pathology; D009669:Nose Neoplasms / Q000473:pathology* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000473:pathology* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery; D013101:Sphenoid Sinus / Q000473:pathology* / Q000601:surgery
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I