Fatal hemorrhage following trans-sphenoidal resection of a pituitary adenoma: a case report and review of the literature

Abstract

A 58-year-old woman with acromegaly developed massive epistaxis 7days following trans-sphenoidal resection of a growth hormone-secreting pituitary adenoma. At autopsy, it was determined that the source of the hemorrhage was a rupture of the intracavernous segment of the internal carotid artery secondary to a bacterial arteritis. We describe the gross dissection and histologic examination undertaken in this unusual case, discuss the possible etiology of the infection and review the potential complications of this surgical approach with a view to improving forensic examination of these patients.