{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:31:39Z","timestamp":1725669099606},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Most pituitary neuroendocrine tumors are benign, except some adenomas that show invasiveness and are called invasive pituitary adenomas. These are challenging and rare pathologies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>We present a case of a 40-year-old male who presented to the emergency with seizures, rhinorrhea, headache, and drowsiness. Radiology images showed a sellar mass with supra-sellar extension and pneumocephalus. The pituitary profile was within normal limits. The patient underwent bifrontal craniotomy and maximum safe resection of the lesion with cerebrospinal fluid (CSF) leak repair and lumbar drain insertion. Histological examination and immunohistochemical stain were consistent with pituitary adenoma. Postoperatively, there was no CSF leak, and the patient\u2019s Glasgow Coma Scale improved.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Rhinorrhea is a unique presentation for pituitary adenoma. According to the current literature, surgery is the only effective treatment as part of the management of invasive pituitary adenomas, along with a multidisciplinary approach.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_224_2024","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T05:29:53Z","timestamp":1725600593000},"page":"318","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive pituitary adenoma presenting with cerebrospinal fluid rhinorrhea and meningitis \u2013 A case report"],"prefix":"10.25259","volume":"15","author":[{"given":"Zanib","family":"Javed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zunaira","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibgha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Altaf","family":"Ali Laghari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"10.25259\/SNI_224_2024\/ref-1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1023\/A:1009931413106","article-title":"Invasive pituitary adenomas: Significance of proliferation parameters","volume":"2","author":"Amar","year":"1999","journal-title":"Pituitary"},{"key":"10.25259\/SNI_224_2024\/ref-2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1756-0500-7-9","article-title":"Acute aseptic meningitis as the initial presentation of a macroprolactinoma","volume":"7","author":"Boscolo","year":"2014","journal-title":"BMC Res Notes"},{"key":"10.25259\/SNI_224_2024\/ref-3","first-page":"54","article-title":"Handbook of neurosurgery","volume-title":"Neuroophthalmology","volume":"35","author":"Cohn","year":"2011","edition":"7th edition"},{"key":"10.25259\/SNI_224_2024\/ref-4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1007\/s11102-019-00960-0","article-title":"Non-functioning pituitary adenomas: Indications for pituitary surgery and post-surgical management","volume":"22","author":"Esposito","year":"2019","journal-title":"Pituitary"},{"key":"10.25259\/SNI_224_2024\/ref-5","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1590\/0004-2730000002961","article-title":"Prolactinoma","volume":"58","author":"Glezer","year":"2014","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"10.25259\/SNI_224_2024\/ref-6","doi-asserted-by":"crossref","first-page":"CASE2029","DOI":"10.3171\/CASE2029","article-title":"Pituitary stone resulting in visual dysfunction and spontaneous rhinorrhea in nonfunctioning pituitary adenoma: Illustrative case","volume":"1","author":"Kanemitsu","year":"2021","journal-title":"J Neurosurg Case Lessons"},{"key":"10.25259\/SNI_224_2024\/ref-7","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2012.4.FOCUS1268","article-title":"Spontaneous and medically induced cerebrospinal fluid leakage in the setting of pituitary adenomas: Review of the literature","volume":"32","author":"Lam","year":"2012","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_224_2024\/ref-8","first-page":"V05180331","article-title":"Pituitary adenoma","volume":"181","author":"M\u00f8ller","year":"2019","journal-title":"Ugeskr Laeger"},{"key":"10.25259\/SNI_224_2024\/ref-9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ecl.2014.10.008","article-title":"Invasive, atypical and aggressive pituitary adenomas and carcinomas","volume":"44","author":"Sav","year":"2015","journal-title":"Endocrinol Metab Clin North Am"},{"key":"10.25259\/SNI_224_2024\/ref-10","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.3390\/cancers11121936","article-title":"Pituitary adenomas and invasiveness from anatomo-surgical, radiological, and histological perspectives: A systematic literature review","volume":"11","author":"Serioli","year":"2019","journal-title":"Cancers (Basel)"},{"key":"10.25259\/SNI_224_2024\/ref-11","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1590\/2359-3997000000179","article-title":"A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the neuroendocrinology department of the Brazilian society of endocrinology and 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