Two-Staged Approach with Endoscopic Endonasal Followed by Open Craniotomy for Excision of Giant Functional Pituitary Adenoma for Remission of Acromegaly

A 45-year-old woman presents with new-onset seizures was found to have a giant sellar and suprasellar pituitary adenoma causing acromegaly. The Knosp grade-IV tumor had significant left cavernous sinus invasion extending through the oculomotor triangle causing temporal lobe compression with subarachnoid invasion. A two-stage approach with expanded transcavernous endoscopic endonasal followed by orbito-zygomatic craniotomy with a Dolenc approach allowed for complete resection and improvement of acromegaly symptoms without permanent complications.

Publication History

Article published online:
07 February 2025