[Transsphenoidal surgery for a case of empty sella syndrome associated with GH secreting pituitary adenoma]

A 33-year-old woman was admitted to our hospital with acromegalic face as her chief complaint. Her neurological examination was normal, and endocrinological examination revealed a high level of growth hormone (GH) (12.8 ng/ml). CT cisternography and MRI showed an enlarged empty sella and a pituitary tumor. We performed a transsphenoidal approach operation to remove the tumor and to repair the empty sella. The tumor, which was compressed to the lateral and posterior wall of the sella turcica by the empty sella, was totally removed by meticulous curetting. It was histologically diagnosed to be a pituitary adenoma. The empty sella was elevated by coagulation of intrasellar dura and herniated arachnoid membrane, and then we filled the residual intrasellar cavity with bone fragments and fat. Postoperative hormonal examination showed normal findings, and MRI revealed obliteration of the empty sella. Surgical indication for primary empty sella is not established, but in cases associated with pituitary adenoma, transsphenoidal surgery is necessary. We reported a case of empty sella syndrome associated with GH secreting pituitary adenoma, and in this report, we introduced a new surgical technique for repairing an empty sella.