A rare case of pituitary macroadenoma with synchronous suprasellar meningioma. Case report, surgical strategy and review of literature

Main Article Content

Bogdan Ionut David
Ligia Gabriela Tataranu
Vasile Gheorghe Ciubotaru
Aurelia Mihaela Sandu
Radu Mircea Gorgan

Abstract

Synchronous tumours can be found all along the entire neuraxis, however, some lesions are far less likely to coexist. One of these extremely rare associations is between GH-pituitary adenomas and suprasellar meningiomas. A wide spectrum of transcranial and transsphenoidal approaches were described in the literature for either sellar, suprasellar and parasellar lesions, but no agreement has been reached for the cases of simultaneous occurring lesions.


We present a rare case of a woman with GH-secreting pituitary adenoma and concomitant suprasellar meningioma. The strategy chosen was sequential transsphenoidal surgeries. However, after the first surgery, the remaining tumour mass did not mobilize as expected due to gravity, hence we decided to perform a transcranial subfrontal unilateral approach. Surprisingly, the second surgery revealed a different histopathological result.


Association of a GH-pituitary adenoma and suprasellar meningioma is very rare, only 17 cases being reported in the relevant literature so far.  Different authors prefer different strategies, ranging from only transsphenoidal to simultaneous transsphenoidal and transcranial approaches, but no general consensus was established.


In conclusion, the existence of synchronous tumours of the sellar region should be taken into account when imaging studies reveal an intracranial mass developing both sellar and suprasellar. The surgical strategy should be tailored to every specific patient and experience of the neurosurgeon.

Article Details

How to Cite
David, B., Tataranu, L., Ciubotaru, V., Sandu, A., & Gorgan, R. (2020). A rare case of pituitary macroadenoma with synchronous suprasellar meningioma. Romanian Neurosurgery, 34(1), 26-30. Retrieved from https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1335
Section
Articles
Author Biographies

Bogdan Ionut David

PhD Student, University of Medicine and Pharmacy “Carol Davilaˮ, Bucharest, ROMANIA

Department of Neurusurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, ROMANIA

Ligia Gabriela Tataranu

University of Medicine and Pharmacy “Carol Davilaˮ, Bucharest, ROMANIA

Department of Neurusurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, ROMANIA

Vasile Gheorghe Ciubotaru

Department of Neurusurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, ROMANIA

Aurelia Mihaela Sandu

Department of Neurusurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, ROMANIA

Radu Mircea Gorgan

University of Medicine and Pharmacy “Carol Davilaˮ, Bucharest, ROMANIA

Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, ROMANIA