Incidental finding of thrombosed aneurysm inside huge pituitary macroadenoma: a case report and review of literature

Although apoplexy and cystic formation are common inside the pituitary adenoma and hemorrhage with different times of occurrence as revealed by magnetic resonance imaging sequences can be seen within a pituitary macroadenoma, a classic saccular aneurysm and its association with carotid artery haven’t been yet reported. Case: A 52 years old woman was referred for visual loss and headache accompanied by pituitary adenoma. She has no particular past medical history was operated her huge pituitary macroadenoma was resected by endoscopic endonasal transsphenoidal surgery. During surgery we encountered a tough saccular mass and checking imaging brought the conjecture of a thrombosed aneurysm. By careful dissection and use of intranasal Doppler sonography its association with left internal carotid was revealed. After coagulation of its main branch that was probably a tumor feeder aneurysm resected totally and we proceed for further tumor removal. Up to our knowledge and review of the related literatures it is the first time that intra adenoma thrombosed aneurysm is reported.