CC BY-NC-ND 4.0 · J Neurol Surg Rep 2021; 82(03): e25-e31
DOI: 10.1055/s-0041-1735904
Case Report

Management of Coincident Pituitary Macroadenoma and Cavernous Carotid Aneurysm: A Systematic Literature Review

Keenan J. Piper
1  Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Michael Karsy
2  Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Blair Barton
3  Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Mindy Rabinowitz
3  Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Marc R. Rosen
3  Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Gurston G. Nyquist
3  Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
James J. Evans
2  Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Stavropoula Tjoumakaris
2  Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Christopher J. Farrell
2  Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
› Author Affiliations
Funding Publication made possible in part by support from the Thomas Jefferson University Open Access Fund.

Abstract

Introduction Pituitary adenomas are a common intracranial pathology with an incidence of 15 to 20% in the population while cerebral aneurysms are less common with a prevalence of 1:50 patients. The incidence of aneurysms in patients with pituitary adenoma has been estimated at 2.3 to 5.4% of patients; however, this remains unclear. Equally, the management of concomitant lesions lacks significant understanding.

Methods A case report is presented of a concomitant cerebral aneurysm and pituitary adenoma managed by minimally invasive endovascular and endoscopic methods, respectively. A systematic review of the literature for terms “pituitary adenoma” and “aneurysm” yielded 494 studies that were narrowed to 19 relevant articles.

Results We report a case of a 67-year-old patient with an enlarging pituitary macroadenoma, cavernous carotid aneurysm, and unilateral carotid occlusion. After successful treatment of the aneurysm by a pipeline flow diverter, the pituitary adenoma was surgically resected by an endoscopic transsphenoidal approach.

Conclusion The use of a pipeline flow diverter and endonasal approach was feasible in the treatment of our patient. This is the first report to our knowledge of the use of pipeline flow diversion in the management of a cavernous carotid aneurysm prior to pituitary adenoma treatment.

Ethics Statement

Michael Karsy reports disclosure with Cyrus Surgical (part owner) and Thieme Medical Publishing (royalties).




Publication History

Received: 08 November 2020

Accepted: 26 May 2021

Publication Date:
29 September 2021 (online)

© 2021. The Author(s). 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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