Pituitary Adenoma Presenting with True Bitemporal Hemianopsia: A Case Report

Abstract

Pituitary adenomas grow from the anterior pituitary gland and can cause compression of surrounding structures, including the optic chiasm, leading to visual field defects such as bitemporal hemianopia, visual acuity or color perception reduction. In this case report, we present the case of a 45-year-old male patient who presented with long-lasting headaches and visual disturbances, including diplopia and a decline in visual acuity. Despite being initially diagnosed with migraine by a neurologist, a thorough ophthalmological examination revealed visual field defects consistent with true bitemporal hemianopsia. MRI results confirmed the presence of sellar mass, and the patient was referred to the neurosurgery department for immediate intervention. The patient underwent surgical removal of the mass, which was identified as a pituitary adenoma upon histological examination. Three months later, the patient experienced significant improvements in subjective and objective visual acuity, with no diplopia or scotomas in the visual field. In conclusion, this case report highlights the importance of considering pituitary adenoma as a potential cause of visual disturbances, even in the absence of bitemporal hemianopsia. Thorough ophthalmological examination, including visual field testing, can aid in the early detection of chiasmal involvement and prompt referral for further investigation. Early intervention, including surgical removal of the tumor, can prevent other complications and significantly improve visual acuity and overall quality of life for patients.

Keywords

• pituitary adenoma
• sellar mass
• bitemporal hemianopsia