Tuberculum sellae meningioma symptomatic during pregnancy: pathophysiological considerations

Acta neurochirurgica
F H EbnerJ Honegger

Abstract

A 31 year old woman in her second pregnancy presented in the 31st (+4) week of gestation with progressive visual impairment of the right eye. Magnetic resonance imaging (MRI) demonstrated a tuberculum sellae meningioma that was displaced upward by a markedly enlarged pituitary gland. Neuro-ophthalmological follow-up examinations showed a progressive decrease of visual acuity and right temporal field loss. Therefore, a caesarean section was performed in the 34th (+8) week. The meningioma was removed three days after childbirth via a right-sided pterional approach. Post-operatively, visual function was completely restored. Immunohistochemical examination showed positive staining for progesterone receptors (PR) in approximately 50% of tumour cells. Enlargement of the pituitary gland during late pregnancy in conjunction with a preexisting tuberculum sellae meningioma is the most likely pathophysiological factor responsible for visual loss. Enlargement of the PR-positive meningioma in the hormonal milieu of pregnancy might have contributed additionally to visual loss.

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Citations

Apr 19, 2013·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·H Wilhelm
Oct 8, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Stylianos PikisEyal Itshayek
Sep 15, 2012·Neurologia Medico-chirurgica·Satoshi ShitaraKazuhiko Nozaki
Jul 16, 2013·World Neurosurgery·Samuel MoscoviciSergey Spektor
Sep 3, 2010·Acta neurochirurgica·Helene CebulaSébastien Froelich
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