Related Experiment Videos
[Intracavernous invagination of pituitary macro-adenomas]
F X Roux1, M Kalamarides, B Devaux
1Service de Neurochirurgie, C.H. Sainte-Anne, Paris.
Annales D'Endocrinologie
|January 1, 1996
Summary
Pituitary adenoma invasion of the cavernous sinus (CS) is often overestimated on imaging. Anatomical variations and normal pituitary gland expansions into the CS can mimic true invasion, impacting treatment decisions.
Area of Science:
- Neurosurgery
- Endocrinology
- Radiology
Context:
- Pituitary adenomas can extend into the cavernous sinus (CS), a critical anatomical space.
- Previous estimates of CS invasion by pituitary adenomas range widely (9-40%).
- Radiological imaging (CT and MRI) often suggests invasion, but confirmation is rare.
Purpose:
- To re-evaluate the frequency of true intra-cavernous invasion by pituitary adenomas.
- To differentiate between normal pituitary gland invagination and pathological invasion.
- To clarify the diagnostic criteria for cavernous sinus invasion.
Summary:
- This study found true intra-cavernous invasion in only 0.8% of cases, despite radiological suspicion in 13.6%.
- Anatomical dissections revealed normal pituitary glands naturally expand into the CS in 30% of cases.
- This normal invagination can be mistaken for tumor invasion on imaging, especially when the adenoma enlarges the gland.
Impact:
- Highlights the need for careful interpretation of imaging for pituitary adenoma cavernous sinus invasion.
- Suggests that many cases previously considered invasive may be normal anatomical variants.
- Emphasizes that trans-sphenoidal surgery is often feasible for complete tumor removal, including lateral expansions.