Pituitary

, Volume 10, Issue 3, pp 299–305 | Cite as

MRI finding of simultaneous coexistence of growth hormone-secreting pituitary adenoma with intracranial meningioma and carotid artery aneurysms: report of a case

  • Lorenzo Curto
  • Stefano Squadrito
  • Barbara Almoto
  • Marcello Longo
  • Francesca Granata
  • Francesco Salpietro
  • Maria L. Torre
  • Fiorella Marini
  • Francesco Trimarchi
  • Salvatore Cannavo
Case Report

Abstract

Coexistence of pituitary adenoma, intracranial meningioma and cerebral aneurysm has never been described. We report on a patient with GH-secreting pituitary macroadenoma associated with a right frontal meningioma and with two intracavernous asymptomatic aneurisms. A 61-year-old woman was referred to our Endocrine Unit 13 years after a right frontal craniotomy for a pituitary tumour. Endocrine investigation showed high levels of IGF-1 (560 ng/ml) and increased basal serum GH (56 ng/ml) levels, not suppressed after OGTT. MRI showed persistence of a homogeneously enhancing intra- and suprasellar lesion, compressing the visual pathways, with bilateral intracavernous invasion and simultaneous coexistence of a right intracavernous internal carotid artery (ICA) aneurysm in direct contact with the pituitary tumour. Somatostatin analog treatment normalized GH and IGF-1 levels. Eight months later, the patient underwent a balloon ICA occlusion with disappearance of the right ICA aneurysm. One year later, a new MRI confirmed the presence of the pituitary mass showing also a right intracranial frontal meningioma and a new ICA aneurysm on the left side. Previous studies have suggested that prolonged GH hypersecretion could play a role in the genesis of intracranial aneurysms, inducing atherosclerotic and/or degenerative modification of the arterial walls. Other aetiological factors include a mechanical effect due to a direct contact between adenoma and aneurysm. Coexistence of pituitary adenoma and intracranial meningioma is a rare event, but also for this association it has been suggested that GH or other growth factors could play a role in appearance or in growth of meningioma. In our case, meningioma appeared and grew, despite the effective treatment of acromegaly.

Keywords

Pituitary adenoma Growth hormone Meningioma Cerebral aneurysm 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Lorenzo Curto
    • 1
    • 4
  • Stefano Squadrito
    • 1
  • Barbara Almoto
    • 1
  • Marcello Longo
    • 2
  • Francesca Granata
    • 2
  • Francesco Salpietro
    • 3
  • Maria L. Torre
    • 1
  • Fiorella Marini
    • 1
  • Francesco Trimarchi
    • 1
  • Salvatore Cannavo
    • 1
  1. 1.Department of Medicine and Pharmacology, Unit of EndocrinologyUniversity of MessinaMessinaItaly
  2. 2.Service of NeuroradiologyUniversity of MessinaMessinaItaly
  3. 3.Department of NeurosurgeryUniversity of MessinaMessinaItaly
  4. 4.Azienda Ospedaliera Universitaria, “Policlinico G. Martino”, Servizio di EndocrinologiaPoliclinico Universitario di MessinaMessinaItaly

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