Abstract

The patient with pituitary adenoma presents himself initially because of endocrine manifestations and later, when the tumor extends beyond the sella turcica, because of pressure symptoms on the neighboring structures, foremost of which is the optic chiasm. The goal of any operative intervention is to relieve the pressure on the optic nerves and chiasm and the remaining functioning pituitary tissue. The patient in the case illustrated presented with an unusually large tumor causing indentation into the floor of the third ventricle which could lead to obstruction of the intraventricular pathways (Figs. 99 and 100). Surgery is, in addition, intended to open these pathways. Such large suprasellar extensions are more frequently seen in craniopharyngiomas (see Chapter V).

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