3 years ago

Endoscopic Endonasal Removal of Large Calcified Pituitary Adenoma: Case Report and Review of the Literature

Makoto Murase, Masahiro Toda, Kentarou Ohara, Eriko Ishihara, Kazunari Yoshida

Publication date: March 2019

Source: World Neurosurgery, Volume 123

Author(s): Makoto Murase, Masahiro Toda, Kentarou Ohara, Eriko Ishihara, Kazunari Yoshida

Background

Large calcified intrasellar masses, called pituitary stones, have been reported as calcified pituitary adenomas in the literature. Although relatively rare, calcified pituitary adenomas appear in various formations. Thus, whether the lesion is removable—and, if so, which approach is appropriate—mainly depends on its formation and quality.

Case Description

A 46-year-old woman presented with visual loss and amenorrhea. Although computed tomography showed a uniformly calcified sellar tumor, magnetic resonance imaging displayed heterogenous intensity on T2-weighted images and mild gadolinium enhancement, suggesting that the lesion was a mixture of pituitary adenoma and fine calcification. Thus, we undertook tumor resection via an endoscopic endonasal approach, which resulted in total removal. The pathological diagnosis was a pituitary adenoma with rich calcification.

Conclusions

We report a rare case of a large pituitary stone that was successfully removed via an endoscopic endonasal approach. This could therefore be a feasible, effective technique for the removal of pituitary stones, although careful analysis of preoperative magnetic resonance imaging is required.

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