2025 Poster Presentations
P214: CONCURRENT WHO GRADE 1 MENINGIOMA AND SOMATOTROPH PITUITARY NEUROENDOCRINE TUMOR: A CASE REPORT AND LITERATURE REVIEW
Chenyi Yang; Joshua Kurtz, MD; Nischal Acharya; Jordan Davies; Frank Hsu; UCI
Introduction: Cases of concurrent meningiomas and pituitary neuroendocrine tumors (PitNETs) are rare. Meningiomas are often noncancerous tumors arising from the arachnoid mater, whereas PitNETs arise from neuroendocrine cells. The presence of meningioma can overshadow the diagnosis of a concurrent PitNET.
Objective: We present a patient with low-grade meningioma, later found to have a concurrent PitNET. We aim to highlight the complexity of managing patients with multiple intracranial tumors. We also conducted a literature review to contextualize the current case within the broader spectrum of dual intracranial neoplasms.
Methods: 56-year-old woman with diabetes presented with expressive aphasia, right-sided weakness, and memory loss. MRI revealed a left-sided skull base mass encasing the left anterior circulation with extension into middle cranial fossa, cavernous sinus, sella, and posterior fossa. She underwent staged transcranial resections, with pathology confirming a low-grade meningothelial meningioma. Follow-up MRI demonstrated residual meningioma and growth of the parasellar component, and patient had signs/symptoms of acromegaly. Subsequent pituitary function tests revealed elevated growth hormone and IGF-1 levels. The patient underwent endoscopic endonasal resection of the pituitary tumor, with pathology confirming a somatotroph PitNET. The patient reported improved acromegalic features postoperatively, with no CSF leak or new visual changes. Surveillance MRI scans are ongoing for tumor recurrence/progression.
Results: In our literature review, multiple articles reported the coexistence of meningiomas and PitNETs. However, the postoperative emergence/diagnosis of a PitNET was rare. In the few reported instances, the delay in diagnosing PitNET often resulted from the initial focus on the more symptomatic meningioma.
Conclusion: The coexistence of meningioma and PitNET poses diagnostic and therapeutic challenges. This case emphasizes the need for comprehensive evaluation and follow-up in patients with intracranial tumors and the potential for successful surgical outcomes with collaborative care.