Pre- and peroperative misdiagnosed sellar tumour

We describe the case of a 76-year old woman complaining of headaches and progressive sight loss. Cerebral CT scan and MRI disclosed a large sellar tumour. Endocrine evaluation showed no evidence of pituitary hypersecretion, but a slight hyperprolactinemia related to stalk compression. A non-functioning pituitary adenoma was suspected. The pathological diagnosis was however a meningioma. In the literature, about 5% of sellar tumours are not pituitary adenomas and this is an alternate diagnosis to consider in the presence of non-secreting macroadenomas.