Endoscopic Extracapsular Removal of Pituitary Adenoma: The Importance of Pretreatment of an Adjacent Unruptured Internal Carotid Artery Aneurysm
Figure 1
(a) Enhanced-MRI coronal image. (b) Enhanced-MRI sagittal image. An intrasellar mass lesion with suprasellar extension is suggestive of a pituitary adenoma with diameters of 17 × 16 × 11 mm. A flow void mass in the left supraclinoid internal carotid artery raised the suspicion of a cerebral aneurysm ((a) arrow). (c) MR angiography confirms a left supraclinoid internal carotid artery aneurysm (measuring approximately 6.0 mm in diameter). (d) Cerebral angiography. (e) Enhanced-MRI coronal image. The aneurysm is treated by endovascular coil placement ((e) arrow). (f) Intraoperative photograph. Pseudocapsule-based extracapsular resection of the pituitary tumor via a transnasal transsphenoidal endoscopic approach is performed. Coil-embolized aneurysm (arrow) is noted adjacent to pituitary adenoma (arrow).
