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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 391-393
DOI: 10.4103/ajns.AJNS_397_20
Case Report

A case of nonapoplectic pituitary adenoma presenting with isolated oculomotor nerve palsy

Kunio Yokoyama
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
,
Naokado Ikeda
1   Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka
,
Akira Sugie
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
,
Makoto Yamada
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
,
Hidekazu Tanaka
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
,
Yutaka Ito
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
,
Masahiro Kawanishi
Department of Neurosurgery, Takeda General Hospital, Fushimi, Kyoto
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We report a rare case of nonapoplectic pituitary adenoma that did not invade the cavernous sinus and was associated with isolated oculomotor nerve palsy. A 61-year-old male was admitted to our hospital due to diplopia that had gradually worsened from 6 months to presentation. He was diagnosed with right oculomotor nerve palsy, and brain magnetic resonance imaging (MRI) showed a mass lesion within the sella. The tumor was homogeneously enhanced on contrast-enhanced MRI. However, no findings suggestive of pituitary apoplexy were found. Brain computed tomography revealed the tumor to have eroded the right side of the posterior clinoid process by gradual expansion. Endoscopic transsphenoidal surgery was used for complete resection of the tumor. Intraoperative findings showed that the tumor did not invade the cavernous sinus. The histological diagnosis was pituitary adenoma, and symptom improvement was observed from the early postoperative stage onward. Surgical treatment is essential because oculomotor nerve palsy caused by the enlargement of pituitary adenoma is not expected to resolve if treated conservatively, unlike that caused by pituitary apoplexy.

Key-words:

Isolated oculomotor nerve palsy - microendoscopic transsphenoidal surgery - nonapoplexy pituitary adenoma

Financial support and sponsorship

Nil.




Publication History

Received: 14 August 2020

Accepted: 28 March 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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