Pituitary Adenoma Concomitant with Chiari I Malformation: Case Report and Literature Review

World Neurosurg. 2019 Sep:129:45-48. doi: 10.1016/j.wneu.2019.05.088. Epub 2019 May 20.

Abstract

Background: Pituitary adenomas (PA) are usually benign neoplasms. Chiari I malformation (CIM) is an uncommon finding. Isolated cases associating functional PA and CIM have been reported. The concomitant presence of a nonfunctional PA and a CIM has not yet been described in the literature.

Case description: We present the case of a 35-year-old patient whose symptoms were compatible with CIM. Magnetic resonance imaging of the brain, with and without contrast material, confirmed the CIM and incidentally encountered a PA. The patient was treated initially for her PA through an endoscopic endonasal approach with complete tumor resection, confirming a nonfunctional PA. Posterior fossa decompression was successfully accomplished 3 months later. The patient has been followed up for 5 years and has been free of symptoms, with no recurrence of her PA. This represents the first reported case of a nonfunctional PA with a concomitant CIM.

Conclusion: This is the first reported case of a concomitant CIM and a nonfunctional PA. We discuss our successful management and conduct a systematic review of the literature to provide the most up-to-date guidance on managing these singular cases with concomitant pathologic conditions.

Keywords: Chiari I malformation; Endoscopic endonasal approach; Pituitary adenoma; Skull base.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Adenoma / complications*
  • Adenoma / diagnosis
  • Adenoma / surgery
  • Adult
  • Arnold-Chiari Malformation / complications*
  • Arnold-Chiari Malformation / surgery
  • Female
  • Humans
  • Incidental Findings
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery