Intrasellar aneurysm and a growth hormone-secreting pituitary macroadenoma. Case report

J Neurosurg. 2004 Mar;100(3):557-9. doi: 10.3171/jns.2004.100.3.0557.

Abstract

An aneurysm completely included within a pituitary adenoma that lies inside the sella turcica is rare and challenging from both a diagnostic and treatment viewpoint. A 39-year-old woman presented with symptoms and signs of acromegaly. Magnetic resonance imaging revealed a pituitary macroadenoma, which was associated with an intrasellar aneurysm. Digital subtraction angiography confirmed the presence of the cavernous carotid artery aneurysm. Complete endovascular obliteration of the aneurysm was achieved using Guglielmi Detachable Coils and the patency of the internal carotid artery was maintained. The pituitary adenoma was resected subtotally via a transsphenoidal microsurgical approach 8 months later. Preoperative detection of a coexisting intrasellar aneurysm in a patient with a pituitary adenoma is mandatory to avoid life-threatening hemorrhagic complications. Endovascular coil placement is an effective treatment option when performed before the transsphenoidal removal of the adenoma.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications*
  • Adenoma / metabolism*
  • Adult
  • Female
  • Human Growth Hormone / metabolism*
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / pathology
  • Magnetic Resonance Imaging
  • Neurosurgical Procedures / methods
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / metabolism*
  • Sella Turcica / pathology*

Substances

  • Human Growth Hormone