Review Timeline | CrossMark Policy | ClinMed Features
logo
 
Neurosurgery - Cases and Reviews ISSN: 2643-4474

Citation

Giorgianni A, Veiceschi P, Agresta G, Balbi S, Locatelli D (2018) Giant Prolactinoma and Concomitant Internal Carotid Artery Pseudo-Aneurysm: All Stages of the Decision-Making Process. Neurosurg Cases Rev 1:007. doi.org/10.23937/ncr-2017/1710007

Copyright

© 2018 Giorgianni A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/ncr-2017/1710007

Giant Prolactinoma and Concomitant Internal Carotid Artery Pseudo-Aneurysm: All Stages of the Decision-Making Process

A Giorgianni1, P Veiceschi2*, G Agresta2, S Balbi3 and D Locatelli2

1Department of Neuroradiology, University of Insubria, Varese, Italy

2Department of Neurosurgery, University of Insubria, Varese, Italy

3Department of Biotechnology and Life Sciences, Unit of Neurosurgery, University of Insubria, Varese, Italy.

Abstract

We report a case of right internal carotid artery pseudo-aneurysm, arising in the aspects of a giant macroadenoma in a 57-years-old man, presented with right severe temporal orbital headache and vomiting.

Computed tomography scan (CT) revealed a destructive skull base mass extended from sellar region to clivus. Pre and post-gadolinium brain magnetic resonance (MRI) confirmed the lesion, characterized by an encasement of optic nerves and carotid siphons bilaterally, with a pseudo-aneurysm of cavernous segment of the right internal carotid artery (ICA).

The patient underwent endoscopic biopsy of the endonasal portion of the lesion with a subsequent diagnosis of prolactinoma. Endovascular therapy using Derivo® 5 × 25 mm, Acandis® flow diversion embolization device was performed. After subsequent hormonal therapy with Cabergoline, a six months follow-up MRI and digital subtractions angiography (DSA) demonstrated reduction of both tumour and pseudo-aneurysm volume.