Extract

A 24-yr-old male was admitted with headaches and recurrent syncope for 2 yr. Laboratory tests confirmed pan-hypopituitarism and diabetes insipidus requiring vasopressin, cortisol, and levothyroxine replacement. Brain magnetic resonance imaging showed a 10- × 6.8- × 6.6-cm tumor centered in the sella compressing the optic chiasm. Figure 1 is a contrast-enhanced T1-weighted coronal image showing a 5-cm exophytic component extending into the right lateral ventricle. Figure 2 is a sagittal view showing a 2.7-cm posterior component compressing the third ventricle and the aqueduct. The hydrocephalus was relieved by external ventricular drain placement followed by transfrontal partial tumor resection. Pathology showed a nonfunctioning pituitary adenoma with negative immunohistochemical stains. Pituitary adenomas are slow-growing tumors within the sella turcica. However, they may grow aggressively and are considered invasive when they infiltrate the dura mater, cranial bone, or sphenoid sinus. Invasive pituitary adenomas account for approximately 35% of all pituitary neoplasms, and treatment consists of surgery and radiotherapy (1).

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