A pituitary gland squeezed upward by intrasellar kissing carotid arteries: Mimicking a pituitary microadenoma

• Published in: Surgical neurology international Vol. 15; p. 372
• Main Authors: Inoue, Eri, Fujio, Shingo, Hosoyama, Hiroshi, Yoshimura, Shinichiro, Moinuddin, FM, Hanaya, Ryosuke, Arita, Kazunori
• Format: Journal Article
• Language: English
• Published: 11.10.2024
• ISSN: 2229-5097; 2152-7806
• DOI: 10.25259/SNI_559_2024

Background: Intrasellar kissing carotid arteries are a rare variant in which bilateral internal carotid arteries run very near each other at their cavernous sinus portion. We encountered a woman with the pituitary gland mimicking a pituitary microadenoma because the pituitary gland was compressed bilaterally by intrasellar kissing carotid arteries. Case Description: A 61-year-old woman with a chronic headache underwent magnetic resonance imaging, which revealed a sellar mass measuring 10.2 mm in height, 8.2 mm in length, and 4.0 mm in width at the midintercarotid level. Blood levels of all pituitary and target-organ hormones were within normal range. The height and superior convex shape of the sellar mass suggested that it was a nonfunctioning microadenoma, which was monitored over the past 16 years. A recent three-dimensional reconstruction of magnetic resonance angiography clearly showed that the pituitary gland was squeezed upward, compressed bilaterally, and extended superiorly by intrasellar kissing carotid arteries. Conclusion: The pituitary gland can be squeezed upward by intrasellar kissing carotid arteries and mimic pituitary tumor.