Not all sellar masses are macroadenomas: think also in metastasis.

A 54-year-old woman presented with a 3-month-history of blurred vision and refractory headache. Examination revealed severe bilateral visual acuity compromise, normal campimetry and bilateral papilledema. As a mean to investigate raised intracranial pressure, neuroimaging studies were performed and showed extensive sellar mass (Figure). Patient underwent transsphenoidal approach for resection of pituitary mass which disclosed metastasis of neuroendocrine lung tumor. Chest CT showed a mass in the anterior segment of right lower lobe of lung. Although symptomatic pituitary gland tumors are common in clinical practice, metastatic disease represent a rare cause of sellar tumors, mainly of breast and lung primary origin.