Development of internal carotid artery aneurysm after successful conservative treatment of prolactinoma

Abstract

Background. The problem of concomitant pituitary adenomas and intracranial aneurysms is extensively covered in literature. According to various authors, the prevalence of such a combination of lesions is as high as 9 %, most commonly involving hormone‑producing pituitary adenomas and aneurysms of the anterior circulation, up to 69 % of which originate from the carotid artery.Aim. To analyze and demonstrate the treatment of patients with developed internal carotid artery aneurysm (ICA) against the background of successful conservative therapy of prolactinoma. Materials and methods. In this article we review the literature and present two clinical cases of patients with development of internal carotid artery (ICA) aneurysms after successful conservative treatment of prolactinomas.Results. In both of the described cases, ICA aneurysms with intrasellar extension developed after successful conservative treatment of large invasive prolactinomas. In both cases ICA occlusion were performed and in one of them extra‑intracranial bypass surgery was performed as well.Conclusion. The presented clinical cases suggest potential direct destructive effect of tumor tissue on vessel walls. Currently, it seems reasonable to carry out computed tomography angiography in all patients with adenomas invading the cavernous sinus.