Endoscopic Endonasal Resection of a Synchronous Pituitary Adenoma and a Tuberculum Sellae Meningioma: Technical Case Report

摘要

OBJECTIVE: The presence of a sellar macroadenoma wilh a concomitant luherc ulum sellae meningioma lyp-icalk requires a craniolomy for extirpation of the meningioma. We describe a single endoscopic approach lot-resection of both lesions. PRESENTATION: A52-vear-old woman wilh complaints of continuous headache and right temporal visual field loss was found to have a 1.9X 2.1 X1.7-cm enhancing sellar mass on magnetic resonance imaging scans associated with a second enhancing extra-axial lesion at ihe planum sphenoidale measuring 1.0 X {).(? cm and encroaching on the right optic nerve. INTERVENTION: After the endoscopic transnasal resection of the pituitary tumor, the planum sphenoidale was drilled and the underlying dura was incised. The suprascl-lar tumor was identified and completely resected. Histologic a! evaluation confirmed the concomitant presence ol a meningioma ,d pituitary adenoma. CONCLUSION: Wilh advances in endoscopic and image-guidance technology and increasing understanding of the endoscopic anatomy of the sellar region, surgeons are capable ol" reaching both intrasellar and suprasellar/ anterior cranial base region tumors through a single endoscopic approach. The use of endoscopes in transsphe-noidal approaches may obviate the need for additional craniolomies in properlv selected patients.