Clinical Problem Solving: Monster on the Hook—Case Problems in Neurosurgery

Author:

Muh Carrie R1,Boulis Nicholas M1,Chandler William F2,Barkan Ariel L2,Mosunjac Marina B3,Oyesiku Nelson M1

Affiliation:

1. Department of Neurological Surgery, Emory University Hospital, Atlanta, Georgia

2. Department of Department of Neurosurgery, Department of Internal Medicine University of Michigan Health System, Ann Arbor, Michigan

3. Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, Georgia

Abstract

AbstractBACKGROUND AND OBJECTIVE:Nonfunctioning and functioning pituitary tumors can present in numerous ways. They may be difficult to diagnose correctly and, even with proper treatment, may lead to complications.METHODS:We present the case of a patient who presented with a large, invasive sellar mass and underwent both medical and surgical treatment for this lesion. The patient's course did not progress as was expected from his initial workup.RESULTS:The patient's history, physical examination, laboratory values, pathologic specimens, and radiologic findings are discussed. His management before, during, and after medical therapy and surgery is reviewed by pituitary experts from 2 different institutions. Aspects of diagnosis and management of sellar lesions are presented and reviewed in the literature.CONCLUSION:Neurosurgeons frequently treat patients with sellar lesions and should remember that despite modern laboratory, pathologic, and radiologic techniques, the diagnosis and treatment of these lesions is not always clear.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

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