An Intrasellar Meningioma Masquerading as Pituitary Apoplexy

Abstract

Intrasellar meningiomas are uncommon tumours, and rarely present with acute symptoms. We describe a 63-year-old woman with an intrasellar mass that presented with sudden headache and severe loss of vision. Magnetic resonance imaging (MRI) was consistent with the clinical diagnosis of pituitary apoplexy, but trans-sphenoidal surgery and biopsy unexpectedly revealed an intrasellar meningioma, and excision could not be completed. A subsequent craniotomy was performed in order to remove the remainder of the tumour. Pre-operative differentiation of an intrasellar meningioma from a pituitary macroadenoma is important as it determines the method of surgical excision, but the two lesions may be indistinguishable even with modern neuro-imaging techniques.

Keywords:

• Sellar meningioma
• intrasellar meningioma
• mimicking pituitary apoplexy
• pituitary macroadenoma