Abstract
Giant pituitary adenomas represent a significant surgical and diagnostic challenge; giant pituitary adenomas with a development that goes beyond the sella can be difficult to manage surgically due to the narrowness of the space and the proximity of important anatomical structures which are at risk according to the surgical approach and its extension in the cavum with absence of endocrine sign can be misinterpreted as cancer of the cavum which was the case for our patient refer to the neurosurgery department after 3 inconclusive biopsies by nasofibroscopy and after visual deterioration.
Highlights
Giant pituitary adenomas can be defined as adenomas with a vertical height exceeding 4 cm. the large size of these tumors and the frequent involvement of neurovascular structures make surgery a real challenge; the problems of surgery are specific and very different from those of small tumors. the suprasellar cistern, the interpeduncular fossa, the third ventricle, the cavernous sinus, the sphenoid sinus and the clivus are the neighboring structures frequently invaded by this kind of tumors [1], [2]
MRI: anterior pituitary increases of heterogeneous size exceeding at the level sphenoidal sinus with 3 nodular lesions, the largest of which 11.3 × 8 mm
A biopsy of the cavum by rhinocavoscopy: caval mucosa exuded without signs of neoplasia or specificity MRI revealed anterior pituitary increases in heterogeneous size protruding at the level sphenoidal sinus with 3 nodular lesions including the largest 11.3× 8 mm
Summary
Giant pituitary adenomas can be defined as adenomas with a vertical height exceeding 4 cm. the large size of these tumors and the frequent involvement of neurovascular structures make surgery a real challenge; the problems of surgery are specific and very different from those of small tumors. the suprasellar cistern, the interpeduncular fossa, the third ventricle, the cavernous sinus, the sphenoid sinus and the clivus are the neighboring structures frequently invaded by this kind of tumors [1], [2]. Giant pituitary adenomas can be defined as adenomas with a vertical height exceeding 4 cm. The large size of these tumors and the frequent involvement of neurovascular structures make surgery a real challenge; the problems of surgery are specific and very different from those of small tumors. The suprasellar cistern, the interpeduncular fossa, the third ventricle, the cavernous sinus, the sphenoid sinus and the clivus are the neighboring structures frequently invaded by this kind of tumors [1], [2]. We report a case report of giant pituitary adenoma with extension into sphenoid sinus and nasopharynx
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