Coexisting Pituitary Adenoma and Suprasellar Meningioma. Report of Two Cases and Review of Literature

Abstract

Background: The coexistence of PA and another type of brain tumor is a very rare clinical scenario. The pathogenesis of coexistence of different lesions in the sella and suprasellar region has not been elucidated. Two cases of concomitant brain tumors are reported. Both tumors occurred in the sellar region .The literature is reviewed on this topic and the possible pathogenesis and management protocol of similar lesions are discussed.

Case presentation: A 37-year-old lady presented with history of oligomenorrhea and headache. Imaging revealed tumor located within the sella and another dural based lesion lying over the planum sphenoidale.

Another case a 42 year old man was referred to our department with the diagnosis of Acromegaly. Imaging revealed the intrasellar lesion and also a suprasellar lesion.in two cases a transsphenoidal adenomectomy and decompression of the optic apparatus was achieved using a right pterional craniotomy and vision improved remarkably.

Conclusion: In our experience, it is suggested; a-using high quality imaging can preclude loosing golden time for preservation of vision in these CCBT, b- surgical approach should be tailored according to the individual patient's symptom, the feasibility of resection all two tumor in one session for the attending surgeons experience. It is important to distinguish between an adenoma coexisting with a suprasellar meningioma because the treatment strategy for these tumors is different .The ideal approach for treatment of such concomitant tumors is not clear due to lack of adequate experience in the literature.

 Keywords: Suprasellar meningioma, Pituitary adenoma, Multiple primary brain tumor