Apoplectic Silent Crooke Cell Adenoma with Adjacent Pseudoaneurysms: Causation or Bystander?

Randall G. Krug, Alice Y. Chang, Aditya Raghunathan, Jamie Van Gompel

Research output: Contribution to journalArticle

Abstract

Background: Crooke cell adenomas (CCAs) are rare and potentially aggressive pituitary tumors that often invade the cavernous sinuses. Although clinical presentations of pituitary tumors may include the development of accompanying intracranial aneurysms, there are no documented cases of coexistent intracranial aneurysms and CCAs to date. Herein we describe an apoplectic silent CCA that presented with adjacent cavernous internal carotid artery (ICA) aneurysms. Case Description: A 45-year old male patient presented for evaluation of headaches and diplopia. Subsequent imaging series revealed a hemorrhagic pituitary macroadenoma that had invaded the left cavernous sinus and circumferentially involved the ICA. Two pseudoaneurysms were visualized along regions of the ICA directly attached to the tumor. A transnasal transsphenoidal endoscopic approach was used for resection of the tumor, which was identified histologically as a CCA. Endocrine evaluations characterized the tumor as nonfunctional. The patient experienced an excellent recovery with resolution of related symptoms. A pseudoaneurysm was treated with a Pipeline embolization device; however, it persisted at last follow-up. Conclusions: CCAs are a poorly characterized and rare pituitary tumor type. In this case, an apoplectic silent CCA invaded the left cavernous sinus and presented with pseudoaneurysms along its involvement of the ICA. Accordingly, the authors speculated that the invasive qualities of this silent corticotroph adenoma may have directly contributed to the development of these aneurysms.

LanguageEnglish (US)
Pages480-484
Number of pages5
JournalWorld neurosurgery
Volume122
DOIs
StatePublished - Feb 1 2019

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False Aneurysm
Causality
Adenoma
Internal Carotid Artery
Cavernous Sinus
Pituitary Neoplasms
Intracranial Aneurysm
Aneurysm
ACTH-Secreting Pituitary Adenoma
Neoplasms
Diplopia
Headache
Equipment and Supplies

Keywords

  • Aneurysms
  • Apoplexy
  • Crooke cell adenoma
  • Pituitary gland

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Apoplectic Silent Crooke Cell Adenoma with Adjacent Pseudoaneurysms : Causation or Bystander? / Krug, Randall G.; Chang, Alice Y.; Raghunathan, Aditya; Van Gompel, Jamie.

In: World neurosurgery, Vol. 122, 01.02.2019, p. 480-484.

Research output: Contribution to journalArticle

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