In the nose, not the sella: Case report of an ectopic pituitary adenoma

Abstract

Background and importance: Ectopic pituitary adenomas presenting in the nasal and paranasal sinuses are very rare. We report a patient with a large ectopic nonfunctioning pituitary macroadenoma involving the nasal passageways, ethmoid sinus, and extending through the cribriform plate extradurally to the anterior fossa with no involvement of the sella turcica. The patient presented with epistaxis and denied any visual disturbances or other associated clinical presentations that would demonstrate extensive cranial nerve involvement. Ectopic pituitary adenomas should be considered in the differential diagnosis of a nasal mass involving the nasal sinuses, even if there is no communication with the sella. Clinical presentation: The patient is a 46-year-old male who presented with complete nasal obstruction. MRI revealed a large bilateral nasal mass extending into the anterior fossa through the cribriform plate. On nasal endoscopy, the patient was found to have a large mass occluding the entire nasal cavity. Subsequently, an endoscopic endonasal resection was performed. Conclusion: This case represents a rare presentation of an ectopic pituitary adenoma. The extensive tumor involvement of the nasal passageways, ethmoid sinuses, and the anterior fossa with the absence of cranial nerve involvement are notable. Histopathologic confirmation of the ectopic pituitary tumor was made after complete endoscopic endonasal removal.