ECTOPIC NON FUNCTIONAL PITUITARY ADENOMA – A CASE REPORT

Non-contrast computerized topography paranasal sinuses showed the presence of a large ill-defined soft-tissue mass in the base of the skull extending to sphenoid sinuses, bilateral choanal, abutting the hard palate, causing erosion of the clivus, dorsum sellae, bilateral pterygoid plates, and posterior surface of the vomer. Contrast-enhanced magnetic resonance (MR) imaging brain and neck revealed a large, lobulated, soft-tissue signal intensity mass of size ~ 4.6 (anteroposterior) × 5.5 (transverse) × 3.4 (craniocaudal) cm almost isointense to T1/T2/fluid-attenuated inversion recovery weighted images arising from the clivus, extending into nasopharynx significantly occluding the airway causing erosion of pterygoid plates, basisphenoid bone with thinning of floor of the sella, and extending in bilateral sphenoid sinuses. However, the pituitary gland appeared normal. MR angiography of cerebral vessels showed normal flow-related enhancement of major intracranial arteries Multiple brownish soft-tissue pieces for histopathological measuring 4 cm × 3 cm × 1 was and E ABSTRACT Ectopic pituitary adenoma comprises 1–2% of all pituitary adenomas with a slight female predominance. Cases have been reported in the sphenoid sinus, cavernous sinus, parasellar region, nasal cavity, clivus, nasopharynx, and third ventricle. Here, we report the case of a 48-year-old female patient who presented with a 2 years history of nasal obstruction, epistaxis, and headache. The patient underwent necessary hematological, biochemical, and radiological investigations. Magnetic resonance imaging brain with angiography study showed a large soft-tissue mass in nasopharynx eroding the clivus and extending to involve bilateral sphenoid sinuses and parasellar region. The airway was also compromised. The pituitary gland appeared normal. All hematological and biochemical investigations were within normal limits. An endoscopic biopsy was also done. Tissue was submitted for histopathological examination and a diagnosis of pituitary adenoma was given. The patient had uneventful post-operative recovery and regularly came for follow-up.