[Para- and suprasellar meningioma coincident with a hormonally active intrasellar hypophyseal adenoma--case report]

We observed a 53 year old man, who presented with a progressive impotence, a decrease of libido and a left sided defective vision. A MRI-study detected a left-sided meningioma para- and suprasellar and an intrasellar adenoma of the anterior lobe of pituitary. The pituitary function tests revealed a prolactinoma. Both tumors could be removed via a left-sided frontolateral approach. Histological examination confirmed the diagnosis of an endotheliomatous meningioma and a prolactinoma. The persistence of elevated prolactin serum level gave necessity of dopamine agonist therapy postoperatively. Postoperatively left sided visus improved slightly. The importance of MRI-study is discussed. Nowadays multiplanar MRI is necessary for planing an optimal neurosurgical approach. The literature is reviewed and the coincidence of the two tumors of sellar region is discussed. We believe in an accidental coincidence, even if there are some hints, which may point out a relation in the pathogenesis of meningiomas and adenomas of the adenohypophysis.