Pituitary Adenoma with Cavernous Sinus Involvement

Abstract

During the past few years, because of a better understanding of the anatomy of the sellar and parasellar regions and of the cavernous sinus, it has been possible to develop a series of microsurgical techniques that allow access to vascular and tumor lesions involving the anteromedial region of the skull base. Of these lesions, pituitary adenomas are the most important because of their frequency. These tumors may present with invasive characteristics that project them out of the pituitary fossa in different directions: 1. over the diaphragma sella into the suprasellar region, anterior cranial fossa, or posteriorly towards the clivus; 2. through the sellar floor into the sphenoidal sinus and nasal cavities; 3. laterally towards the cavernous sinus, either displacing or invading it and in this direction extending under the dura into temporal fossa or Meckel’s cavum.