Journal of Endocrinological Investigation

, Volume 14, Issue 11, pp 975–979 | Cite as

Giant aneurysms of the sellar region simulating pituitary adenomas: A diagnosis to be considered

  • Marcia Jeha Kayath
  • A. M. J. Lengyel
  • R. Nogueira
  • O. TeliaJr.
  • M. A. Czepielewski
Case Report


Aneurysms of the sellar region are commonly mistaken for pituitary adenomas, since they have similar clinical, endocrinological and neurological symptoms. The authors describe three patients with giant aneurysms of the internal carotid artery which were initially diagnosed as pituitary tumors. In all patients the clinical presentation was nonspecific, and consisted mainly of neurological symptoms such as headaches and visual field defects. Endocrine abnormalities were also found in the three cases. Patient no. 1 had short stature, lack of GH response to Clonidine stimulation, low IGF-1 levels and blunted TSH response to TRH. Patient no. 2 had gonadotropin deficiency and patient no. 3 had hyperprolactinemia. CT scans showed a densely enhanced lesion in all patients, which was heterogeneous in one case and homogeneous in the remaining. Carotid angiography confirmed the diagnosis of aneurysm. Preoperative angiographic studies are necessary for the differential diagnosis of an aneurysm from a pituitary tumor. Furthermore, these studies could prevent the serious consequences of a transsphenoidal surgical approach in misdiagnosed cases.


Pituitary adenomas Giant aneurysms hypopituitarism 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    White J.C., Ballantime H.T. Intrasellar aneurysms simulating hypophyseal tumours. J. Neurosurg. 18: 34, 1961.PubMedCrossRefGoogle Scholar
  2. 2.
    Arseni C., Ghitescu M., Critescu A., Mihaila G. Intrasellar aneurysms simulating hypophyseal tumors. Eur. Neurol. 3: 321, 1970.PubMedCrossRefGoogle Scholar
  3. 3.
    Van T. Hoff, Honabrook R.W. Hypopituitarism associated with intracranial aneurysms. Br. Med. J. 4: 1190, 1961.CrossRefGoogle Scholar
  4. 4.
    Shantharam W., Clift G.V. Suprasellar aneurysm- An unusual cause of hypopituitarism. JAMA 229: 1473, 1974.PubMedCrossRefGoogle Scholar
  5. 5.
    Verbalis J.G., Nelson P.B., Robinson A.G. Reversible panhypopituitarism caused by a suprasellar aneurysm: the contribution of mass effect to pituitary dysfunction. Neurosurgery 10: 604, 1982.PubMedCrossRefGoogle Scholar
  6. 6.
    Cartlidge N.E.F., Shaw D.A. Intrasellar aneurysm with subarachnoid hemorrhage and hypopituitarism. J. Neurosurg. 36: 640, 1972.PubMedCrossRefGoogle Scholar
  7. 7.
    Ooi T.C., Russel N.A. Hypopituitarism resulting from an intrasellar aneurysm. Can. J. Neurol. Sci. 13: 70, 1986.PubMedGoogle Scholar
  8. 8.
    Nukta E.M., Taylor H.C. Panhypopituitarism secondary to an aneurysm of the anterior communicating artery. Can. Med. Assoc. J. 137: 413, 1987Google Scholar
  9. 9.
    Dussault J., Plamondon C., Volpe R. Aneurysms of the internal carotid artery simulating pituitary tumors. Can. Med. Assoc. J. 101: 51, 1969.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Sheldon J.J. MRI of the sella. In: Pomeranz S.J. (Ed.), craniospinal magnetic resonance imaging W.B. Saunders Company, Philadelphia, 1989, p. 275.Google Scholar
  11. 11.
    Alvarez O., Ayman O. Even — echo M.R. rephasing in the diagnosis of giant intracranial aneurysms. J. Comput. Assist. Tomogr. 10: 699, 1986.PubMedCrossRefGoogle Scholar
  12. 12.
    Wakai S., Fukushima T., Fuhirata T., Sano K. Association of cerebral aneurysm with pituitary adenoma. Surg. Neurol. 12: 503, 1979.PubMedGoogle Scholar
  13. 13.
    Jaunsolo M.A., Aguirre M., Bellido D., Castro S., Ruiz-Valdepenas M.P., Hawkins F.G. Association d’une acromegalie et d’un aneurysme arteriel cerebral révélé par une hémorragie sous-arachnoidenne. Neurochirurgie 32: 266, 1986.PubMedGoogle Scholar
  14. 14.
    Raymond L.A., Tew J. Large suprasellar aneurysms imitating pituitary tumour. J.Neurol. Neurosurg. Psychiatry. 41: 83, 1978.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 1991

Authors and Affiliations

  • Marcia Jeha Kayath
    • 1
  • A. M. J. Lengyel
    • 1
  • R. Nogueira
    • 1
  • O. TeliaJr.
    • 1
  • M. A. Czepielewski
    • 1
  1. 1.Division of EndocrinologyEscola Paulista de MedicinaSao PauloBrazil

Personalised recommendations