Endoscopic endonasal resection of coexisting pituitary adenoma and meningioma：two cases report and literature review.

Abstract INTRODUCTION: The coexistence of pituitary adenoma（PA）and para/suprasellar meningioma is an extremely rare event, which generally occurs in previous case reports. Literature on the endonasal endoscopic approach (EEA) to treat such synchronous tumors remains sparse. CASE DESCRIPTION: Two cases of concomitant sellar and supra/parasellar tumors are reported. A 62-year-old woman with a PA and a tuberculum sellae meningioma and a 56-year-old woman with a PA and a cavernous sinus (CS) meningioma. Both coexisting tumors were resected through a single extended EEA and achieved a good prognosis. To the best of our knowledge, endoscopic endonasal resection of coexisting PA and CS meningioma has not been previously reported in the literature. CONCLUSION: Our reports add to the literature two cases of coexisting PA and meningioma, with different consistence in sellar and para/suprasellar regions.Furthermore, the present case adds to the evidence that in the rare situation of coexisting sellar and suprasellar tumors located in the same sagittal plane, an extended EEA allows adequate exposure and safe removal of both tumors. However, for tumors coexisting in the sellar and parasellar region in the same coronal plane, we should draw attention to this rare situation for differential diagnosis of synchronous PA and CS meningioma to avoid unnecessary surgery and to decide the best strategy for treatment.