A Case of Intrasellar Meningioma Mimicking Pituitary Adenoma Shigeo MATSUMOTO 1 , Makoto HAYASE 1 , Hirotoshi IMAMURA 1 , Yoshifumi ODA 1 , Haruhiko KIKUCHI 1 , Minako KATAYAMA 2 , Takashi ISHIHARA 2 1Department of Neurosurgery, Kobe City General Hospital 2Department of Endocrinology, Kobe City General Hospital Keyword: intrasellar meningioma , pituitary adenoma , panhypopituitarism , magnetic resonance imaging , intratumoral flow void pp.551-557
Published Date 2001/6/10
DOI https://doi.org/10.11477/mf.1436902056
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The authors report a patient with a rare intrasellar meningioma mimicking pituitary adenoma. A 60-year-old man was admitted to our hospital for evaluation of general fatigue. He had no neurological deficit in-cluding visual function. Endocrinological tests revealed panhypopituitarism. The craniogram showed slightenlargement of the sella turcica with thinning of the dorsum sellae. CT scan and MR imaging demons-trated a homogeneously enhanced intrasellar mass with slight suprasellar extension. Partial removal of themass was performed via the transsphenoidal approach because it was extremely firm and hemorrhagic.Histological diagnosis was transitional meningioma. The patient has been well for two years after surgerywithout tumor progression on MR imaging.

It is mandatory to distinguish intrasellar meningioma from pituitary adenoma preoperatively because ofmarked difference in their treatment strategies. Despite recent advances in neurodiagnostic imaging, it maystill be difficult to differentiate pituitary adenoma from intrasellar meningioma. When we re-evaluated theMR imaging, we recognized that the tumor had demonstrated specific findings, ruling out pituitary adeno-ma, namely bright and homogeneous enhancement, dense enhancement in the early phase on the dynamicMR study, and flow void signal within the mass.

The authors emphasize that careful evaluations of MR imaging will allow the correct preoperative di-agnosis in patients with intrasellar meningioma mimicking pituitary macroadenoma.

Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.


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