Pituitary surgery complicated by haemorrhagic necrosis of residual tumour

Haemorrhagic necrosis of residual pituitary tumour following partial excision has not previously been well described. This is differentiated from post-operative sellar haematoma due to inadequate haemostasis on the basis of absent free clot. The authors report two cases of large macroadenomas with significant supra-sellar extension which were complicated by haemorrhagic necrosis of residual tumour following initial surgery. The literature is reviewed and possible pathophysiogical mechanisms are discussed.