Brain Pathology Case of the Month - August 1999

Contributed by Contributed by: Sergio Vidal PhD1, Luis Syro MD2, Humberto Uribe MD3, Kalman Kovacs MD PhD1, Juan M. Bilbao, MD1. and Eva Horvath PhD1
St. Michael's Hospital, University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto Canada1; Department of Neurosurgery, Clinica Medellin, Hospital Pablo Tobon Uribe2 Medellin Colombia and Department of Neurosurgery, Universidad de Antioquia3, Medellin Colombia.

Published on line in August 1999


This 49 year old woman presented with visual disturbances and a sellar mass measuring 3.1x2.7 cm. She had no endocrine symptoms indicating hormonal hypersecretion or hypopituitarism. Preoperative blood levels of pituitary, thyroid and adrenocortical hormones were within the normal range.

The tumor, believed to be a pituitary adenoma, was removed by transsphenoidal surgery. Six months after the procedure she complained of sudden blindness and MRI documented a large invasive lesion in the sella turcica (Fig. 1). The patient underwent partial tumor resection by the transsphenoidal approach 9 months after the first operation (Fig.1, right). She developed obstructive hydrocephalus and hypopituitarism which required hormone replacement therapy. She died one month after surgery of pulmonary thromboembolism.



International Society of Neuropathology