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Proptosis caused by giant pituitary adenoma: case report

PURPOSE: To describe the unusual occurrence of unilateral proptosis associated with oculomotor palsy and blindness, caused by a giant pituitary adenoma. METHODS: The patient was submitted to clinical and ophthalmologic examination, visual field, magnetic resonance imaging and histopathological study after surgical intervention for the removal of the tumor. RESULTS: A 21-years-old woman had progressive bilateral visual loss, associated with proptosis and limitation of ocular motility of the left eye. Visual field examination revealed a complete temporal hemianopsia in the right eye and no light perception in the left eye. Magnetic resonance imaging showed a large tumor infiltrating the III ventricule, cavernous sinus and orbital apex. The histopathological study revealed a pituitary adenoma producing prolactin and growth hormone without signs of malignancy. CONCLUSIONS: This case is of interest not only because it documents the extremely rare occurrence of orbital involvement by a pituitary tumor but also because it emphasizes the need of an early diagnosis of invasive adenomas since such tumors not necessarily follow a benign clinical course despite their histologically benign nature.

Exophtalmos; Pituitary neoplasms; Pituitary neoplasms; Adenoma; Perimetry; Blindness; Pituitary gland; Case report


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