Metastatic benign pituitary adenomas (PAs), also known as pituitary carcinomas (PCs), represent 0.1–0.2% of all intracranial lesions. They are rare and challenging pathologies. We present the case of a 34-year-old female, who presented to the clinic with headache and visual loss. She was diagnosed with PA with multiple extra-axial metastases. Debulking and biopsy of the lesions was done. Postoperatively, there was gross residual disease, and the patient’s visual disturbances did not improve. Only 165 cases of PCs have been reported in the current literature. Existing consensus on management of these uncommon lesions is based on trial and previously published case reports and surgery appears to be the only definitive treatment. Further research regarding any non-surgical expectant management is warranted.
Background: Cerebral varices are intracranial venous anomalies that are characterized as thin-walled vessels, with a single layer of endothelium lining it and a thin lamina or fibrous connective tissue surrounding it. These varices are usually associated with vascular abnormalities such as arteriovenous malformations or developmental venous anomalies, but may rarely be found as isolated lesions as well. Diagnosis of these isolated lesions on imaging is a challenge, because it is a rare entity and can mimic a space occupying lesion in the brain. The patients with isolated cerebral varix can present with neurological symptoms; however, majority are asymptomatic with the diagnosis made incidentally. Case Description: The aim of this study is to report a case of a 21-month-old boy who was diagnosed with an isolated cerebral varix and had presented with delayed milestones in addition to seizures. His MRI scans showed a solid-cum-cystic lesion with contrast enhancing walls that was excised through craniotomy. Postoperatively, he regained his milestones. Conclusion: The patients with isolated cerebral varix can present with neurological symptoms; however, majority are asymptomatic with the diagnosis made incidentally. These patients have a low risk of bleeding and are treated conservatively, with surgical intervention indicated only in symptomatic patients.
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