Abstract
We have reported an unusual case of pituitary adenoma with extensive calcification from the base of the skull to the right middle fossa. The patient was 28 years old male who was admitted to our department of neurosurgery on September 6, 1976 with the chief complaint of generalized convulsion. Neurological examination on admission revealed irregular bitemporal hemianopsia. There was no sparseness of body hair.
Plain skull films showed extensive suprasellar calcification extending into the right middle fossa. The sella turcica and the sphenoid sinus was completely destroyed and was replaced with a huge calcified mass. Hormonal study revealed a slight hypopituitarism.
On September 30, right frontotemporal craniotomy was performed. Grayish calcified tumor was found originating from the temporal base. It was covered with a thin capsule, easy to bleed and contained many small calcium freckles. Frozen section was reported as squamous cell carcinoma, and extensive tumor removal was abandoned. Postoperatively Cobalt therapy was given. However, paraffin sections showed no malignancy and pituitary adenoma or meningioma was suspected. After a course of irradiation, the second operation was carried out on December 2nd and this calcified tumor was subtotally removed.
Postoperative hormonal studies disclosed prominently high level of the serum prolactin. Light microscopic finding of the specimen taken at the second operation was regarded as chromophobe adenoma, with predominant tendency to degeneration and calcification. Electron microscopically, tumor cells had dilated rough endoplasmic reticulum and sparse secreting granules compatible with prolactin-secreting adenoma cells.
