ABSTRACT
An ectopic pituitary adenoma, exclusively involving the sphenoid sinus, associated with a normal size pituitary gland and an empty sella is a rare clinical entity. Only four cases have been found in the literature. We describe the case of a 47-year-old woman with clinical and biochemical acromegaly. Computed tomography (CT) appeared to show expansion of the sellar floor inferiorly into the sphenoid sinus, and magnetic resonance imaging (MRI) demonstrated an empty sella and a mass lesion confined to the sphenoid sinus. The tumor was totally resected by taking a transnasal endoscopic approach and the dura mater of the base of the pituitary fossa was confirmed intact.
Subject(s)
Acromegaly/etiology , Adenoma/complications , Choristoma/complications , Empty Sella Syndrome/etiology , Human Growth Hormone/metabolism , Paranasal Sinus Neoplasms/complications , Pituitary Neoplasms/complications , Sphenoid Sinus , Adenoma/diagnosis , Choristoma/diagnosis , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Paranasal Sinus Neoplasms/diagnosis , Pituitary Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
A 29-year-old woman with a prolactin microadenoma was under good control with bromocriptine (BCP) therapy until she became pregnant, when the treatment was stopped. During the third trimester of pregnancy the patient presented a unilateral visual loss and intermittent headaches. BCP was restarted and one week later she developed a complete ophthalmoplegia on the other side. The patient was submitted to an endoscopic transnasal transeptal resection of a hematoma and tumoral tissue in the pituitary region. One month after surgery, at 39 weeks of gestation, the patient spontaneously delivered a healthy girl weighing 3 kg, with an Apgar score of 9 and 10 at five minutes. This is the first case in the literature of a pregnant woman with second and third cranial nerve lesions, submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.
Subject(s)
Minimally Invasive Surgical Procedures/methods , Neurosurgical Procedures/methods , Optic Nerve Neoplasms/surgery , Pituitary Neoplasms/complications , Pituitary Neoplasms/surgery , Pregnancy Complications, Neoplastic/surgery , Prolactinoma/complications , Prolactinoma/surgery , Adult , Bromocriptine/therapeutic use , Female , Hematoma , Hemorrhage/etiology , Hemorrhage/pathology , Hormone Antagonists/therapeutic use , Humans , Necrosis , Optic Nerve Neoplasms/pathology , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, ThirdABSTRACT
A 39 years old male patient with a 72 hours evolution of acute abdominal syndrome was submitted to appendicectomy. Fourteen days later he developed headache, vomiting, aphasia, torpor, nuchal stiffness and right hemiplegia. A CT-scan showed multiple brain abscesses on both hemispheres. After aspirative puncture of the largest one, antibiotic treatment was established with total recovery of the patient.
