"Empty sella" with invasive microprolactinoma

We describe the unique association of an aggressive prolactin secreting pituitary microadenoma invading through the sphenoid sinus with an empty sella, in which the pituitary tumor remained clinically undiagnosed. The postmortem anatomy of this empty sella syndrome is presented. It is concluded that the phrase "empty sella", although universally accepted, correlates poorly with the underlying disease, and that terms such as "intrasellar arachnoidocele" or "intrasellar subarachnoid herniation" would be more properly descriptive.